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493 chapters · 14,703 sections in this title.
Tex. Government Code § 540.0854 Benefits Transition From Star Kids To Star+Plus Medicaid Managed Care Program
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Sec. 540.0854. BENEFITS TRANSITION FROM STAR KIDS TO STAR+PLUS MEDICAID MANAGED CARE PROGRAM. The commission shall ensure that there is a plan for transitioning the provision of Medicaid benefits to recipients 21 years of age or older from the STAR Kids managed care program to th…
Tex. Government Code § 540.0855 Utilization Review of Prior Authorizations
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Sec. 540.0855. UTILIZATION REVIEW OF PRIOR AUTHORIZATIONS. At least once every two years, the commission shall conduct a utilization review on a sample of cases for children enrolled in the STAR Kids managed care program to ensure that all imposed clinical prior authorizations ar…
Tex. Government Code § 540.0901 Preferred Drug List Exceptions
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Sec. 540.0901. PREFERRED DRUG LIST EXCEPTIONS. (a) The commission shall adopt rules allowing exceptions to the preferred drug list if: (1) the drug required under the preferred drug list: (A) is contraindicated; (B) will likely cause an adverse reaction in or physical or mental h…
Tex. Government Code § 540A.0001 Definitions
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Sec. 540A.0001. DEFINITIONS. In this chapter: (1) Notwithstanding Section 521.0001(2), "commission" means the Health and Human Services Commission or an agency operating part of the Medicaid managed care program, as appropriate. (2) "Managed care plan" means a plan under which a …