Tex. Government Code § 540.0264
PROVIDER REIMBURSEMENT RATE REDUCTION
Texas · Texas Government Code · Status: effective
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- Citation
- Tex. Government Code § 540.0264, PROVIDER REIMBURSEMENT RATE REDUCTION, Texas, version 1 as recorded 2026-07-09, yourstate.us, https://yourstate.us/provision/656298
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Full text
(a) A contract to which this subchapter applies must require that the contracting Medicaid managed care organization not implement a significant, nonnegotiated, across-the-board provider reimbursement rate reduction unless:
(1) subject to Subsection (b), the organization has the commission's prior approval to implement the reduction; or
(2) the rate reduction is based on changes to the Medicaid fee schedule or cost containment initiatives the commission implements.
(b) A provider reimbursement rate reduction a Medicaid managed care organization proposes is considered to have received the commission's prior approval unless the commission issues a written statement of disapproval not later than the 45th day after the date the commission receives notice of the proposed rate reduction from the organization.