1. (a) OMCAT is established by Texas Government Code §531.9912 in accordance with Texas Government Code §531.9932.
2. (b) OMCAT is responsible for assisting persons who are experiencing barriers in the Medicaid application and enrollment process and educating them so that they understand the concept of managed care; understand their rights under Medicaid, including grievance and appeal procedures; MCOs, health care providers, and any other appropriate entity on and can advocate for themselves. OMCAT intervenes promptly with HHSC Medicaid program staff, behalf of a person who has an urgent need for medical services.
3. (c) As a part of the support and information services, OMCAT is responsible for operating a statewide toll-free assistance telephone number.
4. (d) In accordance with Texas Government Code §531.9932(e), OMCAT is sufficiently independent from other aspects of Medicaid managed care to represent the best interests of consumers in complaint resolution.
5. (e) OMCAT coordinates a network of entities to provide support and information services to persons enrolled in or applying for Medicaid who experience barriers to receiving health care services.

Source Note:The provisions of this §87.51 adopted to be effective April 3, 2025, 50 TexReg 2203.