28 Tex. Admin. Code § 11.1806 – Additional Information That May be Requested From an MCO Participating in Medicaid

(a) Whenever requested by the department, the MCO shall file a complete set of financial exhibits pertaining to the state Medicaid program, in the format of the Managed Care Financial Statistical Report, as may be modified or amended by the Texas Health and Human Services Commission. When a request is received, the MCO shall then file, on two separate occasions, an original Managed Care Financial Statistical Report reflecting the state Medicaid program operations for each contract year in the same format as the monthly Managed Care Financial Statistical Report. These reports shall be in accordance with the instructions promulgated by the Health and Human Services Commission.
(b) For any new or modified request to the Texas Health and Human Services Commission for participation in the Medicaid managed care program, all financial projections, including enrollment projections, from the effective or renewal date of a Medicaid contract that are submitted to the Texas Health and Human Services Commission are also required to be submitted to the Texas Department of Insurance. The MCO shall submit the same financial projections, including a cash flow statement, submitted to the Texas Health and Human Services Commission with the request to participate in the Medicaid program. This information shall be submitted with the certificate of authority if the MCO is not already a licensed MCO. If the MCO is a licensed operation, then the financial projections must be sent with the next financial statement due to the department.
(c) The MCO shall notify the department of any similar financial or statistical reports required by other contracting state agencies and shall submit copies of these reports, when requested by the department.
(d) Information submitted pursuant to this section shall be sent to the Texas Department of Insurance, Financial Analysis & Examinations, Mail Code 303-1A, P.O. Box 149104, Austin, Texas 78714-9104.

Source Note:The provisions of this §11.1806 adopted to be effective November 2, 1998, 23 TexReg 11347; amended to be effective February 24, 2005, 30 TexReg 854.