WebThe key features of the amended Managed Care Freedom of Choice Act are that up to 10% of competing physicians within a health plan's service area could meet and communicate in order to collectively negotiate the following terms and conditions of their contracts with a health plan (although a higher or lower percentage may be authorized by the ... WebAdministration, which includes costs for administering the Texas Medicaid and CHIP programs including MCO contract oversight. • HHSC is required by Rider 195, Limitation on Transfer Authority - Medicaid & CHIP Contracts ... Responsibility for managed care contract oversight and audit of MCO contracts at the agency level is shared among HHSC ...

Contract Reporting and Oversight at the Health and Human …

Web(3) For purposes of this subsection, the Medicaid FFS rates are defined as those rates for providers of services in the Texas Medicaid program for which reimbursement methodologies are specified in Chapter 355 of this title (relating to Reimbursement Rates), exclusive of the rates and payment structures in Medicaid managed care. ohio department of health maternity rules

Managed Care Quality Assurance (MCQA) Office - Texas …

WebTexas has been operating managed care since 1993 when it implemented STAR, which covers acute and primary care services for low-income women and children. Over time, … WebOur Managed Care Contracting team will: Position Clients with targeted, exclusive payor contacts by maximizing unique business leverages and showcasing specialized service capabilities Manage Client demographics and credentialing information required for initial and ongoing contracting Complete Applications WebHHSC has reported 48 active managed care contracts worth $91.7 billion. All have the required attestation letter. The term of each contract varies. 10 Largest MCOs Total Value … ohio department of health insurance