Texas Government Code 540.0054 – Provider and Recipient Education Programs
Current as of: 2024 | Check for updates
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(a) In adopting rules to implement a Medicaid managed care program, the executive commissioner shall establish guidelines for, and require Medicaid managed care organizations to provide, education programs for providers and recipients using a variety of techniques and media.
(b) A provider education program must include information on:
(1) Medicaid policies, procedures, eligibility standards, and benefits;
(2) recipients’ specific problems and needs; and
(3) recipients’ rights and responsibilities under the bill of rights and the bill of responsibilities prescribed by § 532.0301.
Terms Used In Texas Government Code 540.0054
- 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.
- Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
(c) A recipient education program must present information in a manner that is easy to understand. A program must include information on:
(1) a recipient’s rights and responsibilities under the bill of rights and the bill of responsibilities prescribed by § 532.0301;
(2) how to access health care services;
(3) how to access complaint procedures and the recipient’s right to bypass the Medicaid managed care organization’s internal complaint system and use the notice and appeal procedures otherwise required by Medicaid;
(4) Medicaid policies, procedures, eligibility standards, and benefits;
(5) the Medicaid managed care organization’s policies and procedures; and
(6) the importance of prevention, early intervention, and appropriate use of services.
Text of section effective on April 01, 2025