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Texas · Through 89th 2nd Called Legislative Session, 2025

Tex. Government Code § 532.0255: COMPLIANCE STANDARDS AND STANDARDIZED PROCESSES.

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Where this section sits in the code
  1. GOVERNMENT CODE
  2. TITLE 4. EXECUTIVE BRANCH
  3. SUBTITLE I. HEALTH AND HUMAN SERVICES
  4. CHAPTER 532. MEDICAID ADMINISTRATION AND OPERATION IN GENERAL
  5. SUBCHAPTER F. ELECTRONIC VISIT VERIFICATION SYSTEM

(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.

Collected 2026-08-27T01:47:16Z. Source file · JSON

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