SECTION 353.419. Financial Standards  


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  • (a) A managed care organization (MCO) must maintain compliance with the MCO contract requirements, and the Texas Insurance Code and rules promulgated and administered by the Texas Department of Insurance, requiring a fiscally sound operation.

    (b) The Health and Human Services Commission (HHSC) may share in the experience rebates in accordance with §353.3 of this chapter (relating to Experience Rebate in the Managed Care Program).

    (c) HHSC may establish incentive payment programs to encourage MCOs to meet or exceed the goals and objectives of the Medicaid managed care program established by HHSC through its contract.

Source Note: The provisions of this §353.419 adopted to be effective December 18, 1996, 21 TexReg 11822; transferred effective September 1, 2001, as published in the Texas Register May 24, 2002, 27 TexReg 4561; amended to be effective August 10, 2005, 30 TexReg 4466; amended to be effective September 1, 2006, 31 TexReg 6629; amended to be effective March 1, 2012, 37 TexReg 1283