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

Tex. Government Code § 540.0402: CERTIFIER OF ENCOUNTER DATA QUALIFICATIONS.

Where this section sits in the code

GOVERNMENT CODE
TITLE 4. EXECUTIVE BRANCH
SUBTITLE I. HEALTH AND HUMAN SERVICES
CHAPTER 540. MEDICAID MANAGED CARE PROGRAM
SUBCHAPTER I. ENCOUNTER DATA

(a) The state Medicaid director shall appoint a person as the certifier of encounter data.

(b) The certifier of encounter data must have:

(1) demonstrated expertise in estimating premium payment rates paid to a managed care organization under a managed care plan; and

(2) access to actuarial expertise, including expertise in estimating premium payment rates paid to a managed care organization under a managed care plan.

(c) A person may not be appointed as the certifier of encounter data if the person participated with the commission in developing premium payment rates for managed care organizations under managed care plans in this state during the three-year period before the date the certifier is appointed.

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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