1. (a) All Managed Care Organizations (MCO) shall provide services and benefits available to Medicaid recipients under the purchased or fee for service Medicaid program, except services which are excluded from the STAR Program or by contract.
2. (b) The department shall establish the scope and level of benefits which all MCOs must agree to provide as a condition for participation. These requirements may exceed the scope and level of covered benefits and services available to purchased or fee for service Medicaid recipients. These requirements shall be contained in all contracts entered into by MCOs and the department.
3. (c) MCOs are encouraged to provide any services or benefits beyond the level and scope required as a condition for participation in the competitive procurement process. Any services or benefits offered by an MCO beyond those required by the state will be considered as a selection factor during the competitive procurement process. These services or benefits can be any that may make member access to services easier, increase the quality or timeliness of services or benefits offered members, or increase the scope of services offered by the MCO. These services and benefits cannot increase the cost borne or capitation rates paid by the department during any current contract term or in any subsequent contract term. These services or benefits cannot violate any other state or federal rule or regulation.

Source Note:The provisions of this §353.409 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.