1. (a) Entities or individuals who subcontract with a Managed Care Organization (MCO) to provide benefits, perform services, or carry out any essential function of the MCO contract shall meet the same qualifications and contract requirements as the MCO for the service, benefit, or function delegated under the subcontract.
2. (b) Primary Care Case Management (PCCM) and MCOs must reimburse a Federally Qualified Health Center (FQHC), a Rural Health Clinic (RHC), or a municipal health department's public clinic for healthcare services provided to a member outside of regular business hours, as defined at §353.2(55) of this title, at a rate that is equal to the allowable rate for those services as determined under §32.028(e) and (f), Human Resources Code, if the member does not have a referral from the member's primary care provider.
3. (c) The Commission will require all MCOs to comply with the Commission's policy on contracting and subcontracting with historically underutilized businesses (HUBs). The Commission's policy is to meet the goals and good faith effort requirements as stated in the Comptroller of Public Accounts rules at 34 TAC §§20.11 - 20.28 (relating to Historically Underutilized Business Program).

Source Note:The provisions of this §353.407 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 December 25, 2007, 32 TexReg 9594.