SUBCHAPTER

REQUIRED CONTRACT PROVISIONS

Tex. Gov't Code § 540.0251— APPLICABILITY
Tex. Gov't Code § 540.0252— ACCOUNTABILITY TO STATE
Tex. Gov't Code § 540.0253— CAPITATION RATES
Tex. Gov't Code § 540.0254— COST INFORMATION
Tex. Gov't Code § 540.0255— FRAUD CONTROL
Tex. Gov't Code § 540.0256— RECIPIENT OUTREACH AND EDUCATION
Tex. Gov't Code § 540.0257— NOTICE OF MEDICAID CERTIFICATION DATE
Tex. Gov't Code § 540.0258— PRIMARY CARE PROVIDER ASSIGNMENT
Tex. Gov't Code § 540.0259— COMPLIANCE WITH PROVIDER NETWORK REQUIREMENTS
Tex. Gov't Code § 540.0260— COMPLIANCE WITH PROVIDER ACCESS STANDARDS; REPORT
Tex. Gov't Code § 540.0261— PROVIDER NETWORK SUFFICIENCY
Tex. Gov't Code § 540.0262— QUALITY MONITORING PROGRAM FOR HEALTH CARE SERVICES
Tex. Gov't Code § 540.0263— OUT-OF-NETWORK PROVIDER USAGE AND REIMBURSEMENT
Tex. Gov't Code § 540.0264— PROVIDER REIMBURSEMENT RATE REDUCTION
Tex. Gov't Code § 540.0265— PROMPT PAYMENT OF CLAIMS
Tex. Gov't Code § 540.0266— REIMBURSEMENT FOR CERTAIN SERVICES PROVIDED OUTSIDE REGULAR BUSINESS HOURS
Tex. Gov't Code § 540.0267— PROVIDER APPEALS PROCESS
Tex. Gov't Code § 540.0268— ASSISTANCE RESOLVING RECIPIENT AND PROVIDER ISSUES
Tex. Gov't Code § 540.0269— USE OF ADVANCED PRACTICE REGISTERED NURSES AND PHYSICIAN ASSISTANTS
Tex. Gov't Code § 540.0270— MEDICAL DIRECTOR AVAILABILITY
Tex. Gov't Code § 540.0271— PERSONNEL REQUIRED IN CERTAIN SERVICE REGIONS
Tex. Gov't Code § 540.0272— CERTAIN SERVICES PERMITTED IN LIEU OF STATE MEDICAID PLAN SERVICES; ANNUAL REPORT
Tex. Gov't Code § 540.0273— OUTPATIENT PHARMACY BENEFIT PLAN
Tex. Gov't Code § 540.0274— PHARMACY BENEFIT PLAN: REBATES AND RECEIPT OF CONFIDENTIAL INFORMATION PROHIBITED
Tex. Gov't Code § 540.0275— PHARMACY BENEFIT PLAN: CERTAIN PHARMACY BENEFITS FOR SEX OFFENDERS PROHIBITED
Tex. Gov't Code § 540.0276— PHARMACY BENEFIT PLAN: RECIPIENT SELECTION OF PHARMACEUTICAL SERVICES PROVIDER
Tex. Gov't Code § 540.0277— PHARMACY BENEFIT PLAN: PHARMACY BENEFIT PROVIDERS
Tex. Gov't Code § 540.0278— PHARMACY BENEFIT PLAN: PROMPT PAYMENT OF PHARMACY BENEFIT CLAIMS
Tex. Gov't Code § 540.0279— PHARMACY BENEFIT PLAN: MAXIMUM ALLOWABLE COST PRICE AND LIST FOR PHARMACY BENEFITS
Tex. Gov't Code § 540.0280— PHARMACY BENEFIT PLAN: PHARMACY BENEFITS FOR CHILD ENROLLED IN STAR KIDS MANAGED CARE PROGRAM
Tex. Gov't Code § 540.0283— NURSING FACILITY PROVIDER AGREEMENTS: COMPLIANCE WITH PATIENT CARE EXPENSE RATIO
Tex. Gov't Code § 540.02721— PILOT PROGRAM TO PROVIDE ADDITIONAL NUTRITION SUPPORT SERVICES TO CERTAIN PREGNANT RECIPIENTS IN LIEU OF STATE MEDICAID PLAN SERVICES