Texas § GV.540.0054 - PROVIDER AND RECIPIENT EDUCATION PROGRAMS

§ GV.540.0054. PROVIDER AND RECIPIENT EDUCATION PROGRAMS

PROVIDER AND RECIPIENT EDUCATION PROGRAMS. (a) In adopting rules to implement a Medicaid managed care program, the executive commissioner shall establish guidelines for, and require Medicaid managed care organizations to provide, education programs for providers and recipients using a variety of techniques and media. (b) A provider education program must include information on: (1) Medicaid policies, procedures, eligibility standards, and benefits; (2) recipients' specific problems and needs; and (3) recipients' rights and responsibilities under the bill of rights and the bill of responsibilities prescribed by Section 532.0301 . (c) A recipient education program must present information in a manner that is easy to understand. A program must include information on: (1) a recipient's rights and responsibilities under the bill of rights and the bill of responsibilities prescribed by Section 532.0301 ; (2) how to access health care services; (3) how to access complaint procedures and the recipient's right to bypass the Medicaid managed care organization's internal complaint system and use the notice and appeal procedures otherwise required by Medicaid; (4) Medicaid policies, procedures, eligibility standards, and benefits; (5) the Medicaid managed care organization's policies and procedures; and (6) the importance of prevention, early intervention, and appropriate use of services. Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611 ), Sec. 1.01, eff. April 1, 2025.