1 Tex. Admin. Code § 353.405
Marketing
Effective Aug 10, 200530 TexReg 4466Source 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.Texas Secretary of State
- (a) Health Maintenance Organizations (HMOs) must submit a marketing plan and all marketing materials to the Commission for prior written approval.
- (b) HMOs may present their marketing materials to eligible Medicaid clients through any method or media determined to be acceptable by the Commission. The media may include, but are not limited to: written materials, such as brochures, posters, or fliers, which can be mailed directly to the client or left at HHSC eligibility offices; Commission-sponsored community enrollment events; and public service announcements on radio.
- (c) HMO enrollment or marketing representatives are required to complete the Commission's marketing orientation and training program prior to engaging in marketing activities on behalf of the HMO.
(d) Prohibited marketing practices.
- (1) HMOs and providers shall not conduct any direct contact marketing except through Commission-sponsored enrollment events.
- (2) HMOs and providers shall 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) HMOs and Providers shall not make false, misleading or inaccurate statements relating to services or benefits, providers, or potential providers through their plan.
- (4) HMOs and providers shall not offer Medicaid recipients material or financial gain as an inducement for enrollment, unless an exception is made by the Commission.
- (5) Marketing or enrollment practices of HMOs and providers shall 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.
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.