1. (a) As used in this subchapter, a managed care organization is an entity holding a certificate of authority to operate as an HMO under the Insurance Code Chapters 1271 and 843 or as an approved nonprofit health corporation under the Insurance Code Chapter 844.
2. (b) Any managed care organization or other entity providing the services specified in 42 United States Code §1396b(m)(2)(A) and participating in the State Medicaid Program (all hereinafter referred to as an "MCO") must first comply with the requirements and solvency standards set forth in this subchapter, and must not be in a hazardous financial condition as defined in §843.406 of the Texas Insurance Code, §11.810 of this title (relating to Hazardous Conditions for HMOs), or Chapter 8 of this title (relating to Early Warning System for Insurers in Hazardous Condition) where pertinent to managed care organizations. In addition, any MCO already subject to regulation of any kind, must be in compliance with any solvency standard and/or requirement pertinent to its regulation, as well as all applicable licensing laws and regulations.

Source Note:The provisions of this §11.1801 adopted to be effective December 3, 1996, 21 TexReg 11377; amended to be effective February 24, 2005, 30 TexReg 854; amended to be effective November 15, 2006, 31 TexReg 9298.