Tex. Insurance Code § 845.152
PARTICIPATION REQUIREMENT
Texas · Texas Insurance Code · Status: effective
Cite this
- Citation
- Tex. Insurance Code § 845.152, PARTICIPATION REQUIREMENT, Texas, version 1 as recorded 2026-07-09, yourstate.us, https://yourstate.us/provision/679604
- Permanent ID
ys:prov:679604@1- SHA-256
dbe056a3e3b8d143fa7d27dfeab3036b9ae5d5fcc2acc49d7d5a67390b9cd53f
The hash is SHA-256 of this version's text, with every run of whitespace collapsed to a single space and the ends trimmed. The ID always leads back here, and checking it says whether the text you cited is still the current version.
Full text
As a requirement of participation in a state contract awarded under Section 845.151, the system must satisfactorily address the qualifications for arranging to provide health care services to beneficiaries of certain governmental health care programs as delineated in the contractor's request for proposal, including:
(1) readiness reviews and adequacy of credentialing, medical management, quality assurance, claims payment, information management, provider and patient education, and complaint and grievance procedures; and
(2) adequacy of physician and provider networks, including factors such as diversity, geographic accessibility, inclusion of physicians and other providers that have furnished a significant amount of Medicaid or charity care to beneficiaries, and tertiary and subspecialty services.