The Texas Health and Human Services Commission (HHSC) adopted a rule regarding Internet Posting of Sanctions Imposed for Contractual Violations.
HHSC is authorized to impose sanctions against a Medicaid managed care organization for failing to comply with contract terms. During the 30-day comment period, HHSC received one comment:
Comment:
HHSC received a comment from DSHS, in which the commenter suggested adding language to §353.5(a), General Provisions, indicating the rule only applies to managed care organizations that contract directly with HHSC.
HHSC Response:
HHSC acknowledges the comment and disagrees with the commenter. The rule was not revised to include the commenter’s suggested language in §353.5(a), General Provisions. Section 353.5(a) establishes that HHSC determines noncompliance with the terms of a contract to provide health care services to clients through a managed care plan issued “by the MCO.” Based on this language, the rule does not apply to the Medicaid managed care contract at DSHS.
For more details, see the relevant section of the April 20 Texas Register.
