Texas Administrative Code

The department will annually submit a report to FHWA that describes: (1) the total number of project applications received for the federal fiscal year (the period of October 1 through September 30), including the aggregate cost of the projects for which applications are received …

(a) Purpose and need. Access management is an engineering and planning method of balancing the needs of mobility and safety on a highway system with the needs of access to adjacent land uses. Access management is one method of preserving the substantial public investment in the g…

The following words and terms, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise. (1) Access connection--Facility, such as a driveway, street, road, or highway, that connects to a highway on the state highway system fo…

(a) Permit. (1) A permit is required before: (A) the construction of an access connection; or (B) a material change in the use of a permittee's real property, traffic volume for the access connection, or vehicle types using the access connection, that would result in the applicat…

The following words and terms, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise. (1) Commission--Texas Transportation Commission. (2) Department--Texas Department of Transportation. (3) Executive director--The executi…

(a) During a program call administered by the department, TAP funds may be awarded for any of the following activities: (1) construction of on-road and off-road trail facilities for pedestrians, bicyclists, and other non-motorized forms of transportation, including sidewalks, bic…

(a) This section applies only to an MPO serving an urbanized area with a population over 200,000 and the award of TAP funds suballocated for such an urbanized area. (b) The MPO, in consultation with the department, shall develop a competitive process to allow project sponsors to …

(a) The state is required to suballocate, in accordance with 23 U.S.C. § 213 , a part of its TAP apportionment to urbanized areas with populations over 200,000. (b) Each MPO serving an urbanized area with a population over 200,000 shall implement the TAP for the award of funds su…

The following words and terms, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise. (1) Commission--Texas Transportation Commission. (2) Department--Texas Department of Transportation. (3) Executive director--The executi…

The sections under this subchapter prescribe the policies and procedures for the implementation and administration of the Transportation Alternatives Program (TAP), as authorized by 23 U. S. C. § 213 . Notes 43 Tex. Admin. Code § 11.300 Adopted by Texas Register, Volume 39, Numbe…

(a) A project will be eliminated from participation in the TA Set-Aside Program if prior to the execution of the local agreement, the governing body of a municipality or county in which project activities are proposed, by resolution, order, or other official action, notifies the …

(a) On receipt of a financial statement indicating that a delegated entity or delegated third party has an amount of total liabilities greater than its total assets, the HMO must immediately forward a copy of the financial statement to the department. (b) An HMO that becomes awar…

(a) On receipt of complaints, a notice under § 11.2606 of this title (relating to Reporting Requirements), or as otherwise permitted under the Insurance Code or related rules, the department may examine any matter relating to the financial solvency of the delegated entity or dele…

(a) The department may require at any time that a delegated entity take corrective action to comply with the department's statutory and regulatory requirements that: (1) relates to any matters delegated by the HMO to the delegated entity; (2) is necessary to ensure the HMO's comp…

In addition to any other requirements set forth in this subchapter, an HMO that contracts with a delegated network must ensure that the delegated network complies with Insurance Code Chapter 1272, Subchapter D, (concerning Reserve Requirements). The HMO's agreement with the deleg…

(a) An applicant for a certificate of authority to operate an HMO must have unencumbered assets that satisfy the requirements of Insurance Code § 843.403 (concerning Minimum Net Worth). (b) For the purpose of calculating assets to satisfy the minimum net worth requirements of Ins…

(a) Statutory deposits made under Insurance Code § 843.405 (concerning Deposit with Comptroller) consisting of certificates of deposit must be issued by a solvent, federally insured bank. (b) Before issuance of the certificate of authority, the HMO must submit proof of statutory …

The admitted assets of domestic and foreign HMOs must at all times comply with the provisions of this section. (1) Investment of minimum net worth. An HMO must have a minimum net worth as required by § 11.802 of this title (relating to Minimum Net Worth). (2) Investment of assets…

(a) Other assets an HMO may find necessary in its operations include, but are not limited to, the following: (1) uncollected premiums or subscriptions with an adequate provision for uncollectable premiums or subscriptions; (2) advances of capitation or other fees expected to be p…

(a) Subject to compliance with Insurance Code Chapter 843 (concerning Health Maintenance Organizations), this chapter, and other applicable insurance laws and regulations of this state, a domestic HMO, which is a member of a holding company system with assets in an aggregate amou…

Any director, member of a committee, officer, or any representative of a domestic HMO, who is charged with the duty of handling or investing its funds, may not intentionally: (1) deposit or invest the funds, except in the corporate name of the HMO or in the name of the nominee of…

(a) Each HMO must account for liabilities as provided for in § 11.801 of this title (relating to Accounting Guidance), and must segregate its liabilities into classifications of "covered" or "uncovered." Agreements to loan money or to make future capital or surplus contributions …

(a) In compliance with Insurance Code Chapter 1353 (concerning Immunization or Vaccination Protocols Under Managed Care Plans), an HMO may not require a physician to issue an immunization or vaccination protocol for an immunization or vaccination to be administered to an enrollee…

An HMO is subject to the requirements of Insurance Code Chapter 823 (concerning Insurance Holding Company Systems); Insurance Code Chapter 824 (concerning Merger and Consolidation of Stock Insurance Corporations); and Chapter 7, Subchapter B, of this title (relating to Insurance …

The commissioner may require additional information as needed to make any determination required by Insurance Code Chapter 843 (concerning Health Maintenance Organizations) and Insurance Code Chapter 1271 (concerning Benefits Provided by Health Maintenance Evidence of Coverage; C…

(a) HMOs must include the following notice in information provided to new subscribers: Attached Graphic (b) The entire notice must be in at least 10-point type. If the newsletter or other mailing is in larger than 10-point type, the notice must be in the same type as the rest of …

(a) An HMO may not require any pharmacy or pharmacist participating or applying to participate as a contracted provider in an HMO delivery network to: (1) provide financial statements to the HMO; or (2) deposit with the HMO any monies or other form of consideration, except for re…

An HMO may not require an enrollee in a group health plan to pay a premium or contribution that is different from the premium or contribution for a similarly situated enrollee based on a health status-related factor. For purposes of this section, the term "similarly situated" has…

(a) Whenever requested by the department, an MCO participating in Medicaid must file with the department 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…

(a) Basic, single service, and limited service HMOs must develop and maintain an ongoing QI program designed to objectively and systematically monitor and evaluate the quality and appropriateness of care and services and to pursue opportunities for improvement. Unless the HMO has…

The QI program for basic, single service, and limited service HMOs must be continuous and comprehensive, addressing both the quality of clinical care and the quality of services. The HMO must dedicate adequate resources, such as personnel and information systems, to the QI progra…

(a) Except as otherwise provided, words and terms defined in Insurance Code Chapters 823 (concerning Insurance Holding Company Systems), 843 (concerning Health Maintenance Organizations), 1271 (concerning Benefits Provided by Health Maintenance Evidence of Coverage; Charges), 127…

A filing fee required by Insurance Code § 843.154 (concerning Fees), as determined by § 7.1301 of this title (relating to Regulatory Fees), must accompany an application for a certificate of authority, unless the filing is made electronically through the NAIC's System for Electro…

(a) Revisions during the review of an application for a certificate of authority must be addressed to: Company Licensing and Registration Office, Mail Code 103-CL, Texas Department of Insurance, P.O. Box 149104, Austin, Texas 78714-9104, or submitted electronically as instructed …

The application for a certificate of authority must contain the following, in this order: (1) a completed name application form along with any certificate of reservation of corporate name issued by the secretary of state; (2) a completed certificate of authority application form;…

(a) The following documents must be made available for review at the applicant's office in Texas or another location within Texas agreed to by the department and on request during the application process: (1) administrative: policy and procedure manuals; (2) health information sy…

(a) An application for a certificate of authority will be processed in compliance with § 1.809 of this title (relating to HMO Certificate of Authority). (b) After completion of the department's review of documents, the department may perform quality of care and financial examinat…

(a) On written notice to the department, an applicant may request withdrawal of an application for a certificate of authority from consideration by the department. (b) The department may close an application if the department determines that the applicant has failed to respond in…

A Community Health Maintenance Organization (CHMO) is an entity created by one or more community centers under Health and Safety Code § 534.001 (concerning Establishment), and authorized by the department to provide a plan for limited health care services as defined in Insurance …

(a) Each CHMO must comply with all requirements for a limited health care service plan specified in this subchapter. (b) Each CHMO must provide coverage for work in progress and must clearly specify that the enrollee must agree to have the work completed by a participating physic…

(a) Before obtaining a certificate of authority, an applicant CHMO must comply with each requirement for the issuance of a certificate of authority imposed on a limited health care service plan under Insurance Code Chapter 843 (concerning Health Maintenance Organizations) and Ins…

(a) An HMO must provide to each delegated entity with which the HMO has a delegation agreement, at least monthly unless otherwise stated in the agreement and provided in standard electronic format agreed to by the parties, the following information: (1) the name and either the da…

The Board shall periodically conduct a comprehensive audit of all educational and general facilities on the campuses of the Texas State Technical College System as outlined in Chapter 17 of this title (relating to Campus Planning). Notes 19 Tex. Admin. Code § 11.25 The provisions…

(a) The Board shall review any proposed legislation establishing an additional Texas State Technical College campus. The review shall consider the state's need for the new campus. The Board shall report its findings to the Governor and the Legislature. (b) The Board shall make a …

(a) The system may establish an extension program in accordance with Texas Education Code, Section 135.06 , and by approval of the Board. (b) The system may operate an extension center in accordance with Texas Education Code, Section 135.02 , and under continuing review by the Bo…

Per 21 CFR § 112.4 , the following farms are covered by the Produce Safety Rule and this chapter: (1) a farm which produces covered produce sold during the previous 3-year period in an amount more than $25,000 (on a rolling basis), adjusted for inflation using 2011 as the baselin…

(a) Board action on the approval of additional campuses or extension centers, acquisition of land, or new program requests which are not delegated to the Commissioner shall be taken at the quarterly Board meeting after the request has been submitted. (b) A resolution shall be ent…