AUTHORITY OF COMMISSION RELATING TO HEALTH PLAN PROVIDER CONTRACTS

The commission may: (1) implement contracts with health plan providers under Section 62.155; (2) monitor the health plan providers, through reporting requirements and other means, to ensure performance under the contracts and quality delivery of services; (3) monitor the quality of services delivered to enrollees through outcome measurements including: (A) rate of hospitalization for ambulatory sensitive conditions, including asthma, diabetes, epilepsy, dehydration, gastroenteritis, pneumonia, and UTI/kidney infection; (B) rate of hospitalization for injuries; (C) percent of enrolled adolescents reporting risky health behavior such as injuries, tobacco use, alcohol/drug use, dietary behavior, physical activity, or other health related behaviors; and (D) percent of adolescents reporting attempted suicide; and (4) provide payment under the contracts to the health plan providers.