28 Tex. Admin. Code § 10.40

Current through Reg. 49, No. 45; November 8, 2024
Section 10.40 - Management Contracts
(a) A network may not enter into a contract with another entity for management services, or modify a previously approved management contract, unless the proposed contract or modification is first filed with the department and approved by the Commissioner in accordance with Insurance Code § 1305.102, concerning Management Contracts.
(b) For purposes of this chapter, management services include management control and decision-making, and contracting on behalf of the network under a delegation of management authority, power of attorney, or other arrangement.
(c) If a person is serving as both a management contractor or a third party to which the network delegates a function and as an agent of the health care provider, the contract between the management contractor or third party and the health care provider must comply with Insurance Code § 1305.153, concerning Provider Reimbursement.
(d) A management contractor or a third party that is also serving as an agent for one or more health care providers in the certified network must meet the disclosure requirements with the certified network under Insurance Code § 1305.153.

28 Tex. Admin. Code § 10.40

The provisions of this §10.40 adopted to be effective December 5, 2005, 30 TexReg 8099; The provisions of this §10.40 adopted to be effective December 5, 2005, 30 TexReg 8099; Amended by Texas Register, Volume 47, Number 30, July 29, 2022, TexReg 4549, eff. 8/2/2022