- (a) Within 30 days after the end of each reporting period, 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 Department of Health. The MCO shall 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. The first annual report shall reflect data completed through the 90th day after the end of the contract year, and shall be submitted within 120 days after the end of the contract year. The second annual report shall reflect data completed through the 270th day after the end of the contract year, and shall be submitted 300 days after the end of the contract year. The second (final) report shall be accompanied by a written opinion from a CPA attesting to the fact that the subject report presents fairly, in all material respects, the financial and statistical results of the contract's state Medicaid program operations for the period stated therein, in conformity with generally accepted accounting principles consistently applied throughout the reported period(s).
- (b) The MCO shall submit the same financial projections, including a cash flow statement, submitted to the Texas Department of Health with the request for application (RFA). 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 should be sent with the next financial statement due to the department.
- (c) Any similar financial or statistical reports required by other contracting state agencies shall also be submitted to the department in the same manner as described in subsections (a) and (b) of this section.
- (d) Information submitted pursuant to this section shall be sent to the Texas Department of Insurance, Financial Monitoring Unit, 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.