Texas Government Code 543A.0051 – Quality-Based Premium Payments; Performance Reporting
(a) Subject to Section 1903(m)(2)(A), Social Security Act (42 U.S.C. § 1396b(m)(2)(A)), and other federal law, the commission shall base a percentage of the premiums paid to a managed care organization participating in the child health plan program or Medicaid on the organization’s performance with respect to outcome and process measures developed under Section 543A.0002 that address potentially preventable events. The percentage may increase each year.
(b) The commission shall make available information relating to a managed care organization’s performance with respect to outcome and process measures under this subchapter to an enrollee or recipient before the enrollee or recipient chooses a managed care plan.
Text of section effective on April 01, 2025
Terms Used In Texas Government Code 543A.0051
- Year: means 12 consecutive months. See Texas Government Code 311.005