Texas § GV.532.0255 - COMPLIANCE STANDARDS AND STANDARDIZED PROCESSES

§ GV.532.0255. COMPLIANCE STANDARDS AND STANDARDIZED PROCESSES

COMPLIANCE STANDARDS AND STANDARDIZED PROCESSES. (a) In implementing the electronic visit verification system: (1) subject to Subsection (b), the executive commissioner shall adopt compliance standards for health care providers; and (2) the commission shall ensure that: (A) the information required to be reported by health care providers is standardized across Medicaid managed care organizations and commission programs; (B) processes Medicaid managed care organizations require to retrospectively correct data are standardized and publicly accessible to health care providers; (C) standardized processes are established for addressing the failure of a Medicaid managed care organization to provide a timely authorization for delivering services necessary to ensure continuity of care; and (D) a health care provider is allowed to enter a variable schedule into the system. (b) In establishing compliance standards for health care providers under Subsection (a), the executive commissioner shall consider: (1) the administrative burdens placed on health care providers required to comply with the standards; and (2) the benefits of using emerging technologies for ensuring compliance, including Internet-based, mobile telephone-based, and global positioning-based technologies. Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611 ), Sec. 1.01, eff. April 1, 2025.