Provider Network Directories

Sec. 540.0654. PROVIDER NETWORK DIRECTORIES. (a) The commission shall ensure that a Medicaid managed care organization: (1) posts on the organization's Internet website: (A) the organization's provider network directory; and (B) a direct telephone number and e-mail address through which a recipient enrolled in the organization's managed care plan or the recipient's provider may contact the organization to receive assistance with: (i) identifying in-network providers and services available to the recipient; and (ii) scheduling an appointment for the recipient with an available in-network provider or to access available in-network services; and (2) updates the online directory required under Subdivision (1)(A) at least monthly. (b) A Medicaid managed care organization is required to send a paper form of the organization's provider network directory for the program only to a recipient who requests to receive the directory in paper form. Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.