§ 533.001 Definitions
§ 533.002 Purpose
§ 533.0025 Delivery of Services
§ 533.00251 Delivery of Certain Benefits, Including Nursing Facility Benefits, Through Star + Plus Medicaid Managed Care Program
§ 533.00253 Star Kids Medicaid Managed Care Program
§ 533.00254 Star Kids Managed Care Advisory Committee
§ 533.00255 Behavioral Health and Physical Health Services Network
§ 533.002551 Monitoring of Compliance With Behavioral Health Integration
§ 533.002552 Targeted Case Management and Psychiatric Rehabilitative Services for Children, Adolescents, and Families
§ 533.002553 Behavioral Health Services Provided Through Third Party or Subsidiary
§ 533.002555 Transition of Case Management for Children and Pregnant Women Program Recipients to Managed Care Program
§ 533.00256 Managed Care Clinical Improvement Program
§ 533.00257 Delivery of Medical Transportation Program Services Through Managed Transportation Organization
§ 533.002571 Delivery of Nonemergency Transportation Services to Certain Medicaid Recipients Through Medicaid Managed Care Organization
§ 533.00258 Nonmedical Transportation Services Under Medicaid Managed Care Program
§ 533.002581 Delivery of Nonmedical Transportation Services Under Medicaid Managed Care Program
§ 533.0026 Direct Access to Eye Health Care Services Under Medicaid Managed Care Model or Arrangement
§ 533.0027 Procedures to Ensure Certain Recipients Are Enrolled in Same Managed Care Plan
§ 533.0028 Evaluation of Certain Star + Plus Medicaid Managed Care Program Services
§ 533.00281 Utilization Review for Star + Plus Medicaid Managed Care Organizations
§ 533.00282 Utilization Review and Prior Authorization Procedures
§ 533.002821 Prior Authorization Procedures for Hospitalized Recipient
§ 533.00283 Annual Review of Prior Authorization Requirements
§ 533.00284 Reconsideration Following Adverse Determinations On Certain Prior Authorization Requests
§ 533.002841 Maximum Period for Prior Authorization Decision; Access to Care
§ 533.0029 Promotion and Principles of Patient-Centered Medical Homes for Recipients
§ 533.003 Considerations in Awarding Contracts
§ 533.0031 Medicaid Managed Care Plan Accreditation
§ 533.0035 Certification by Commission
§ 533.004 Mandatory Contracts
§ 533.005 Required Contract Provisions
§ 533.0051 Performance Measures and Incentives for Value-Based Contracts
§ 533.00511 Quality-Based Enrollment Incentive Program for Managed Care Organizations
§ 533.00515 Medication Therapy Management
§ 533.0052 Star Health Program: Trauma-Informed Care Training
§ 533.00521 Star Health Program: Health Care for Foster Children
§ 533.00522 Star Health Program: Mental Health Providers
§ 533.0053 Compliance With Texas Health Steps
§ 533.00531 Medicaid Benefits for Certain Children Formerly in Foster Care
§ 533.0054 Health Screening Requirements for Enrollee Under Star Health Program
§ 533.0055 Provider Protection Plan
§ 533.0056 Star Health Program: Notification of Placement Change
§ 533.006 Provider Networks
§ 533.0061 Provider Access Standards; Report
§ 533.0062 Penalties and Other Remedies for Failure to Comply With Provider Access Standards
§ 533.0063 Provider Network Directories
§ 533.0064 Expedited Credentialing Process for Certain Providers
§ 533.0065 Frequency of Provider Credentialing
§ 533.0066 Provider Incentives
§ 533.0067 Eye Health Care Service Providers
§ 533.007 Contract Compliance
§ 533.0071 Administration of Contracts
§ 533.0072 Internet Posting of Sanctions Imposed for Contractual Violations
§ 533.0073 Medical Director Qualifications
§ 533.0075 Recipient Enrollment
§ 533.00751 Recipient Directory
§ 533.0076 Limitations On Recipient Disenrollment
§ 533.0077 Statewide Effort to Promote Maintenance of Eligibility
§ 533.008 Marketing Guidelines
§ 533.009 Special Disease Management
§ 533.0091 Sickle Cell Disease Treatment
§ 533.010 Special Protocols
§ 533.011 Public Notice
§ 533.012 Information for Fraud Control
§ 533.013 Premium Payment Rate Determination; Review and Comment
§ 533.0131 Use of Encounter Data in Determining Premium Payment Rates
§ 533.01315 Reimbursement for Services Provided Outside of Regular Business Hours
§ 533.0132 State Taxes
§ 533.014 Profit Sharing
§ 533.015 Coordination of External Oversight Activities
§ 533.016 Provider Reporting of Encounter Data
§ 533.0161 Monitoring of Psychotropic Drug Prescriptions for Certain Children
§ 533.017 Qualifications of Certifier of Encounter Data
§ 533.018 Certification of Encounter Data
§ 533.019 Value-Added Services
§ 533.020 Managed Care Organizations: Fiscal Solvency and Complaint System Guidelines
§ 533.021 Community Health Workers
§ 533.038 Coordination of Benefits; Continuity of Specialty Care for Certain Recipients
§ 533.039 Delivery of Benefits Using Telecommunications and Information Technology

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Terms Used In Texas Government Code Chapter 533 > Subchapter A - General Provisions

  • Affidavit: means a statement in writing of a fact or facts signed by the party making it, sworn to before an officer authorized to administer oaths, and officially certified to by the officer under his seal of office. See Texas Government Code 312.011
  • Affidavit: A written statement of facts confirmed by the oath of the party making it, before a notary or officer having authority to administer oaths.
  • Allegation: something that someone says happened.
  • Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
  • 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.
  • Arrest: Taking physical custody of a person by lawful authority.
  • Attachment: A procedure by which a person's property is seized to pay judgments levied by the court.
  • Balanced budget: A budget in which receipts equal outlays.
  • Charity: An agency, institution, or organization in existence and operating for the benefit of an indefinite number of persons and conducted for educational, religious, scientific, medical, or other beneficent purposes.
  • Clerk of court: An officer appointed by the court to work with the chief judge in overseeing the court's administration, especially to assist in managing the flow of cases through the court and to maintain court records.
  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • Continuance: Putting off of a hearing ot trial until a later time.
  • Contract: A legal written agreement that becomes binding when signed.
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
  • Dependent: A person dependent for support upon another.
  • Equitable: Pertaining to civil suits in "equity" rather than in "law." In English legal history, the courts of "law" could order the payment of damages and could afford no other remedy. See damages. A separate court of "equity" could order someone to do something or to cease to do something. See, e.g., injunction. In American jurisprudence, the federal courts have both legal and equitable power, but the distinction is still an important one. For example, a trial by jury is normally available in "law" cases but not in "equity" cases. Source: U.S. Courts
  • 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.
  • Fiscal year: The fiscal year is the accounting period for the government. For the federal government, this begins on October 1 and ends on September 30. The fiscal year is designated by the calendar year in which it ends; for example, fiscal year 2006 begins on October 1, 2005 and ends on September 30, 2006.
  • Fraud: Intentional deception resulting in injury to another.
  • Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
  • in writing: includes any representation of words, letters, or figures, whether by writing, printing, or other means. See Texas Government Code 312.011
  • Indemnification: In general, a collateral contract or assurance under which one person agrees to secure another person against either anticipated financial losses or potential adverse legal consequences. Source: FDIC
  • Injunction: An order of the court prohibiting (or compelling) the performance of a specific act to prevent irreparable damage or injury.
  • 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.
  • Justice: when applied to a magistrate, means justice of the peace. 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.
  • Oversight: Committee review of the activities of a Federal agency or program.
  • 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.
  • Pleadings: Written statements of the parties in a civil case of their positions. In the federal courts, the principal pleadings are the complaint and the answer.
  • Population: means the population shown by the most recent federal decennial census. See Texas Government Code 311.005
  • Probable cause: A reasonable ground for belief that the offender violated a specific law.
  • Probation: A sentencing alternative to imprisonment in which the court releases convicted defendants under supervision as long as certain conditions are observed.
  • Property: means real and personal property. See Texas Government Code 311.005
  • Prosecute: To charge someone with a crime. A prosecutor tries a criminal case on behalf of the government.
  • Recess: A temporary interruption of the legislative business.
  • Reporter: Makes a record of court proceedings and prepares a transcript, and also publishes the court's opinions or decisions (in the courts of appeals).
  • Rule: includes regulation. See Texas Government Code 311.005
  • Signature: includes the mark of a person unable to write, and "subscribe" includes the making of such a mark. See Texas Government Code 312.011
  • sworn: includes affirm or affirmed. See Texas Government Code 312.011
  • Testify: Answer questions in court.
  • Testimony: Evidence presented orally by witnesses during trials or before grand juries.
  • Trial: A hearing that takes place when the defendant pleads "not guilty" and witnesses are required to come to court to give evidence.
  • United States: includes a department, bureau, or other agency of the United States of America. See Texas Government Code 311.005
  • Venue: The geographical location in which a case is tried.
  • Week: means seven consecutive days. See Texas Government Code 311.005
  • Writ: A formal written command, issued from the court, requiring the performance of a specific act.
  • 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