Section 540.0264 - [Effective 4/1/2025] Provider Reimbursement Rate Reduction(a) A contract to which this subchapter applies must require that the contracting Medicaid managed care organization not implement a significant, nonnegotiated, across-the-board provider reimbursement rate reduction unless: (1) subject to Subsection (b), the organization has the commission's prior approval to implement the reduction; or(2) the rate reduction is based on changes to the Medicaid fee schedule or cost containment initiatives the commission implements.(b) A provider reimbursement rate reduction a Medicaid managed care organization proposes is considered to have received the commission's prior approval unless the commission issues a written statement of disapproval not later than the 45th day after the date the commission receives notice of the proposed rate reduction from the organization. (Gov. Code, Secs. 533.005(a)(25), (a-3).)Tex. Gov't. Code § 540.0264
Added by Acts 2023, Texas Acts of the 88th Leg.- Regular Session, ch. 769,Sec. 1.01, eff. 4/1/2025.