Tex. Gov't Code § 533.003

Current with legislation from the 2023 Regular and Special Sessions signed by the Governor as of November 21, 2023.

Section 533.003 - [Repealed Effective 4/1/2025] Considerations in Awarding Contracts

(a) In awarding contracts to managed care organizations, the commission shall:

(1) give preference to organizations that have significant participation in the organization's provider network from each health care provider in the region who has traditionally provided care to Medicaid and charity care patients;

(2) give extra consideration to organizations that agree to assure continuity of care for at least three months beyond the period of Medicaid eligibility for recipients;

(3) consider the need to use different managed care plans to meet the needs of different populations;

(4) consider the ability of organizations to process Medicaid claims electronically; and

(5) in the initial implementation of managed care in the South Texas service region, give extra consideration to an organization that either:

(A) is locally owned, managed, and operated, if one exists; or

(B) is in compliance with the requirements of Section 533.004.

(b) The commission, in considering approval of a subcontract between a managed care organization and a pharmacy benefit manager for the provision of prescription drug benefits under Medicaid, shall review and consider whether the pharmacy benefit manager has been in the preceding three years:

(1) convicted of an offense involving a material misrepresentation or an act of fraud or of another violation of state or federal criminal law;

(2) adjudicated to have committed a breach of contract; or

(3) assessed a penalty or fine in the amount of $500,000 or more in a state or federal administrative proceeding.

Tex. Gov't. Code § 533.003

Repealed by Acts 2023, Texas Acts of the 88th Leg.- Regular Session, ch. 769,Sec. 3.01, eff. 4/1/2025.

Amended by Acts 2015, Texas Acts of the 84th Leg. - Regular Session, ch. 1,Sec. 2.221, eff. 4/2/2015.

Amended By Acts 2011, 82nd Leg., 1st C.S., Ch. 7, Sec. 1.02(c), eff. 9/28/2011.

Amended By Acts 1999, 76th Leg., ch. 1460, Sec. 9.02, eff. 9/1/1999.

Amended by Acts 1999, 76th Leg., ch. 1447, Sec. 2, eff. 6/19/1999

Added by Acts 1997, 75th Leg., ch. 1262, Sec. 2, eff. 6/20/1997.