§ 540.0251 Applicability
§ 540.0252 Accountability to State
§ 540.0253 Capitation Rates
§ 540.0254 Cost Information
§ 540.0255 Fraud Control
§ 540.0256 Recipient Outreach and Education
§ 540.0257 Notice of Medicaid Certification Date
§ 540.0258 Primary Care Provider Assignment
§ 540.0259 Compliance With Provider Network Requirements
§ 540.0260 Compliance With Provider Access Standards; Report
§ 540.0261 Provider Network Sufficiency
§ 540.0262 Quality Monitoring Program for Health Care Services
§ 540.0263 Out-of-Network Provider Usage and Reimbursement
§ 540.0264 Provider Reimbursement Rate Reduction
§ 540.0265 Prompt Payment of Claims
§ 540.0266 Reimbursement for Certain Services Provided Outside Regular Business Hours
§ 540.0267 Provider Appeals Process
§ 540.0268 Assistance Resolving Recipient and Provider Issues
§ 540.0269 Use of Advanced Practice Registered Nurses and Physician Assistants
§ 540.0270 Medical Director Availability
§ 540.0271 Personnel Required in Certain Service Regions
§ 540.0272 Certain Services Permitted in Lieu of Other Mental Health or Substance Use Disorder Services; Annual Report
§ 540.0273 Outpatient Pharmacy Benefit Plan
§ 540.0274 Pharmacy Benefit Plan: Rebates and Receipt of Confidential Information Prohibited
§ 540.0275 Pharmacy Benefit Plan: Certain Pharmacy Benefits for Sex Offenders Prohibited
§ 540.0276 Pharmacy Benefit Plan: Recipient Selection of Pharmaceutical Services Provider
§ 540.0277 Pharmacy Benefit Plan: Pharmacy Benefit Providers
§ 540.0278 Pharmacy Benefit Plan: Prompt Payment of Pharmacy Benefit Claims
§ 540.0279 Pharmacy Benefit Plan: Maximum Allowable Cost Price and List for Pharmacy Benefits
§ 540.0280 Pharmacy Benefit Plan: Pharmacy Benefits for Child Enrolled in Star Kids Managed Care Program
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Terms Used In Texas Government Code Chapter 540 > Subchapter F - Required Contract Provisions

  • Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
  • Attachment: A procedure by which a person's property is seized to pay judgments levied by the court.
  • Comptroller: means the state comptroller of public accounts. See Texas Government Code 312.011
  • Contract: A legal written agreement that becomes binding when signed.
  • Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • Fraud: Intentional deception resulting in injury to another.
  • Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
  • Lien: A claim against real or personal property in satisfaction of a debt.
  • Month: means a calendar month. See Texas Government Code 312.011
  • Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
  • Person: includes corporation, organization, government or governmental subdivision or agency, business trust, estate, trust, partnership, association, and any other legal entity. See Texas Government Code 311.005
  • Personal property: All property that is not real property.
  • Remainder: An interest in property that takes effect in the future at a specified time or after the occurrence of some event, such as the death of a life tenant.
  • Remand: When an appellate court sends a case back to a lower court for further proceedings.
  • Restitution: The court-ordered payment of money by the defendant to the victim for damages caused by the criminal action.
  • Rule: includes regulation. See Texas Government Code 311.005
  • Statute: A law passed by a legislature.
  • Subpoena: A command to a witness to appear and give testimony.
  • United States: includes a department, bureau, or other agency of the United States of America. See Texas Government Code 311.005
  • Written: includes any representation of words, letters, symbols, or figures. See Texas Government Code 311.005
  • Year: means 12 consecutive months. See Texas Government Code 311.005