1 Tex. Admin. Code § 353.405
Marketing
Effective Jul 6, 201439 TexReg 4951Source Note: The provisions of this §353.405 adopted to be effective December 18, 1996, 21 TexReg 11822; transferred effective September 1, 2001, as published in the Texas Register May 24, 2002, 27 TexReg 4561; amended to be effective August 10, 2005, 30 TexReg 4466; amended to be effective September 1, 2006, 31 TexReg 6629; amended to be effective March 1, 2012, 37 TexReg 1283; amended to be effective July 6, 2014, 39 TexReg 4951.Texas Secretary of State
- (a) Managed care organizations (MCOs) must submit a marketing plan and all marketing materials to the Health and Human Services Commission (HHSC) for prior written approval.
- (b) MCOs may present their marketing materials to eligible Medicaid clients through any method or media determined to be acceptable by HHSC. The media may include: written materials, such as brochures, posters, or fliers, which can be mailed directly to the client or left at HHSC eligibility offices; enrollment events; and public service announcements on radio.
- (c) MCO enrollment or marketing representatives are required to complete HHSC's marketing orientation and training program prior to engaging in marketing activities on behalf of the MCO.
(d) Prohibited marketing practices.
- (1) MCOs and providers must not conduct any direct contact marketing except through enrollment events or when assisting the MCO's current members with reapplication.
- (2) MCOs and providers must not make any written or oral statement containing material misrepresentations of fact or law relating to their plan or the Medicaid managed care program.
- (3) MCOs and providers must not make false, misleading or inaccurate statements relating to services or benefits, providers, or potential providers through their plan.
- (4) MCOs and providers must not offer Medicaid recipients material or financial gain as an inducement for enrollment, unless an exception is made by HHSC.
- (5) Marketing or enrollment practices of MCOs and providers must not discriminate against a client because of a client's race, creed, age, color, religion, national origin, ancestry, marital status, sexual orientation, physical or mental disability, health status, or existing need for medical care.
- (e) MCO network providers must comply with the standards described in §354.1452 of this title (relating to Provider Marketing).
- (f) Nothing in this section prohibits a provider participating in the STAR+PLUS program from, as permitted under the provider's contract, engaging in a marketing activity, including any dissemination of material or other attempt to communicate, that is intended to educate a Medicaid client about available long-term care services and supports.
Source Note:The provisions of this §353.405 adopted to be effective December 18, 1996, 21 TexReg 11822; transferred effective September 1, 2001, as published in the Texas Register May 24, 2002, 27 TexReg 4561; amended to be effective August 10, 2005, 30 TexReg 4466; amended to be effective September 1, 2006, 31 TexReg 6629; amended to be effective March 1, 2012, 37 TexReg 1283; amended to be effective July 6, 2014, 39 TexReg 4951.