1 Tex. Admin. Code § 353.104

Current through Register Vol. 49, No. 48, November 29, 2024

Section 353.104 - Member Education Program

A member education program must present information in a manner that is easy to understand. In addition to any requirements specified in the contract between the managed care organization (MCO) and the Health and Human Services Commission, a program must include, at minimum, information on:

(1) a member's rights and responsibilities under the Bill of Rights and the Bill of Responsibilities prescribed in Subchapter C of this chapter (relating to Member Bill of Rights and Responsibilities);

(2) how to access dental services or health care services;

(3) how to access complaint and appeal procedures, the member's right to request a fair hearing, and the process for requesting a fair hearing;

(4) Medicaid policies, procedures, eligibility standards, and benefits;

(5) the policies and procedures of the MCO; and

(6) the importance of prevention, early intervention, and appropriate use of services.

1 Tex. Admin. Code § 353.104

The provisions of this §353.104 adopted to be effective February 28, 1997, 22 TexReg 1799; Amended to be effective August 10, 2005, 30 TexReg 4466; Amended to be effective March 1, 2012, 37 TexReg 1283