reglab/housing_qa huggingface dataset:
TX Health & Safety Code § 62.151 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 62 - Child Health Plan for Certain Low-Income Children|Subchapter D. Child Health Plan|Section 62.151. Child Health Plan Coverage

 Sec. 62.151.  CHILD HEALTH PLAN COVERAGE.  (a)  The child health plan must comply with this chapter and the coverage requirements prescribed by 42 U.S.C. Section 1397cc, as amended, and any other applicable law or regulations.(b)  In modifying the covered benefits, the executive commissioner shall consider the health care needs of healthy children and children with special health care needs.(c)  In modifying the plan, the executive commissioner shall ensure that primary and preventive health benefits do not include reproductive services, other than prenatal care and care related to diseases, illnesses, or abnormalities related to the reproductive system.(d)  The child health plan must allow an enrolled child with a chronic, disabling, or life-threatening illness to select an appropriate specialist as a primary care physician.(e)  Repealed by Acts 2015, 84th Leg., R.S., Ch. 837 (S.B. 200), Sec. 3.40(b)(2), and Ch. 946 (S.B. 277), Sec. 2.37(c)(2), eff. January 1, 2016.(f)  If the executive commissioner determines the policy to be cost-effective, the executive commissioner may ensure that an enrolled child does not, unless authorized by the commission in consultation with the child's attending physician or advanced practice nurse, receive under the child health plan:(1)  more than four different outpatient brand-name prescription drugs during a month; or(2)  more than a 34-day supply of a brand-name prescription drug at any one time.|Added by Acts 1999, 76th Leg., ch. 235, Sec. 1, eff. Aug. 30, 1999.  Amended by Acts 2003, 78th Leg., ch. 198, Sec. 2.49, eff. Sept. 1, 2003.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0202, eff. April 2, 2015.Acts 2015, 84th Leg., R.S., Ch. 837 (S.B. 200), Sec. 3.40(b)(2), eff. January 1, 2016.Acts 2015, 84th Leg., R.S., Ch. 946 (S.B. 277), Sec. 2.37(c)(2), eff. January 1, 2016.|
TX Health & Safety Code § 62.155 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 62 - Child Health Plan for Certain Low-Income Children|Subchapter D. Child Health Plan|Section 62.155. Health Plan Providers

Sec. 62.155.  HEALTH PLAN PROVIDERS.  (a)  The commission shall select the health plan providers under the program through a competitive procurement process.  A health plan provider, other than a state administered primary care case management network, must hold a certificate of authority or other appropriate license issued by the Texas Department of Insurance that authorizes the health plan provider to provide the type of child health plan offered and must satisfy, except as provided by this chapter, any applicable requirement of the Insurance Code or another insurance law of this state.(b)  A managed care organization or other entity shall seek to obtain, in the organization's or entity's provider network, the participation of significant traditional providers, as defined by commission rule, if that organization or entity:(1)  contracts with the commission or with another agency or entity to operate a part of the child health plan under this chapter;  and(2)  uses a provider network to provide or arrange for health care services under the child health plan.(c)  In selecting a health plan provider, the commission:(1)  may give preference to a person who provides similar coverage under the Medicaid program;  and(2)  shall provide for a choice of at least two health plan providers in each service area.(d)  The executive commissioner may authorize an exception to Subsection (c)(2) if there is only one acceptable applicant to become a health plan provider in the service area.|Added by Acts 1999, 76th Leg., ch. 235, Sec. 1, eff. Aug. 30, 1999.  Amended by Acts 2003, 78th Leg., ch. 198, Sec. 2.52, eff. Sept. 1, 2003.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0205, eff. April 2, 2015.|
TX Health & Safety Code § 62.1551 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 62 - Child Health Plan for Certain Low-Income Children|Subchapter D. Child Health Plan|Section 62.1551. Inclusion of Certain Health Care Providers in Provider Networks

Sec. 62.1551.  INCLUSION OF CERTAIN HEALTH CARE PROVIDERS IN PROVIDER NETWORKS.  (a)  Notwithstanding any other law, including Sections 843.312 and 1301.052, Insurance Code, the executive commissioner shall adopt rules to require a managed care organization or other entity to ensure that advanced practice registered nurses and physician assistants are available as primary care providers in the organization's or entity's provider network.  The rules must require advanced practice registered nurses and physician assistants to be treated in the same manner as primary care physicians with regard to:(1)  selection and assignment as primary care providers;(2)  inclusion as primary care providers in the provider network; and(3)  inclusion as primary care providers in any provider network directory maintained by the organization or entity.(b)  For purposes of Subsection (a), an advanced practice registered nurse may be included as a primary care provider in a managed care organization's or entity's provider network regardless of whether the physician supervising the advanced practice registered nurse is in the provider network.(c)  This section may not be construed as authorizing a managed care organization or other entity to supervise or control the practice of medicine as prohibited by Subtitle B, Title 3, Occupations Code.|Added by Acts 2013, 83rd Leg., R.S., Ch. 418 (S.B. 406), Sec. 22, eff. November 1, 2013.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0206, eff. April 2, 2015.Acts 2017, 85th Leg., R.S., Ch. 302 (S.B. 654), Sec. 2, eff. September 1, 2017.|
TX Health & Safety Code § 62.156 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 62 - Child Health Plan for Certain Low-Income Children|Subchapter D. Child Health Plan|Section 62.156. Health Care Providers

Sec. 62.156.  HEALTH CARE PROVIDERS.  Health care providers who provide health care services under the child health plan must satisfy certification and licensure requirements, as required by commission rules and consistent with other law.|Added by Acts 1999, 76th Leg., ch. 235, Sec. 1, eff. Aug. 30, 1999.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0207, eff. April 2, 2015.|
TX Health & Safety Code § 62.1561 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 62 - Child Health Plan for Certain Low-Income Children|Subchapter D. Child Health Plan|Section 62.1561. Prohibition of Certain Health Care Providers

Sec. 62.1561.  PROHIBITION OF CERTAIN HEALTH CARE PROVIDERS.  The executive commissioner shall adopt rules for prohibiting a person from participating in the child health plan program as a health care provider for a reasonable period, as determined by the executive commissioner, if the person:(1)  fails to repay overpayments under the program; or(2)  owns, controls, manages, or is otherwise affiliated with and has financial, managerial, or administrative influence over a provider who has been suspended or prohibited from participating in the program.|Added by Acts 2011, 82nd Leg., R.S., Ch. 980 (H.B. 1720), Sec. 8, eff. September 1, 2011.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0208, eff. April 2, 2015.|
TX Health & Safety Code § 62.157 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 62 - Child Health Plan for Certain Low-Income Children|Subchapter D. Child Health Plan|Section 62.157. Telemedicine Medical Services, Teledentistry Dental Services, and Telehealth Services for Children With Special Health Care Needs

Sec. 62.157.  TELEMEDICINE MEDICAL SERVICES, TELEDENTISTRY DENTAL SERVICES, AND TELEHEALTH SERVICES FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS.  (a)  In providing covered benefits to a child with special health care needs, a health plan provider must permit benefits to be provided through telemedicine medical services, teledentistry dental services, and telehealth services in accordance with policies developed by the commission.(b)  The policies must provide for:(1)  the availability of covered benefits appropriately provided through telemedicine medical services, teledentistry dental services, and telehealth services that are comparable to the same types of covered benefits provided without the use of telemedicine medical services, teledentistry dental services, and telehealth services; and(2)  the availability of covered benefits for different services performed by multiple health care providers during a single session of telemedicine medical services, teledentistry dental services, telehealth services, or any combination of those services, if the executive commissioner determines that delivery of the covered benefits in that manner is cost-effective in comparison to the costs that would be involved in obtaining the services from providers without the use of telemedicine medical services, teledentistry dental services, and telehealth services, including the costs of transportation and lodging and other direct costs.(c)  In developing the policies required by Subsection (a), the executive commissioner shall consult with:(1)  The University of Texas Medical Branch at Galveston;(2)  Texas Tech University Health Sciences Center;(3)  the Department of State Health Services;(4)  providers of telemedicine hub sites in this state;(5)  providers of services to children with special health care needs; and(6)  representatives of consumer or disability groups affected by changes to services for children with special health care needs.|Added by Acts 2001, 77th Leg., ch. 959, Sec. 5, eff. June 14, 2001.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0209, eff. April 2, 2015.Acts 2021, 87th Leg., R.S., Ch. 811 (H.B. 2056), Sec. 22, eff. September 1, 2021.Acts 2021, 87th Leg., R.S., Ch. 811 (H.B. 2056), Sec. 23, eff. September 1, 2021.|
TX Health & Safety Code § 62.1571 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 62 - Child Health Plan for Certain Low-Income Children|Subchapter D. Child Health Plan|Section 62.1571. Telemedicine Medical Services and Teledentistry Dental Services

Text of section as amended by Acts 2021, 87th Leg., R.S., Ch. 811 (H.B. 2056), Sec. 24For text of section as amended by Acts 2021, 87th Leg., R.S., Ch. 624 (H.B. 4), Sec. 7, see other Sec. 62.1571.Sec. 62.1571.  TELEMEDICINE MEDICAL SERVICES AND TELEDENTISTRY DENTAL SERVICES.  (a)  In providing covered benefits to a child, a health plan provider must permit benefits to be provided through telemedicine medical services and teledentistry dental services in accordance with policies developed by the commission.(b)  The policies must provide for:(1)  the availability of covered benefits appropriately provided through telemedicine medical services and teledentistry dental services that are comparable to the same types of covered benefits provided without the use of telemedicine medical services and teledentistry dental services; and(2)  the availability of covered benefits for different services performed by multiple health care providers during a single session of telemedicine medical services, teledentistry dental services, or both services, if the executive commissioner determines that delivery of the covered benefits in that manner is cost-effective in comparison to the costs that would be involved in obtaining the services from providers without the use of telemedicine medical services or teledentistry dental services, including the costs of transportation and lodging and other direct costs.(c)  In this section, "teledentistry dental service" and "telemedicine medical service" have the meanings assigned by Section 531.001, Government Code.|Added by Acts 2001, 77th Leg., ch. 1255, Sec. 4, eff. June 15, 2001.Redesignated and amended from Health and Safety Code, Section 62.157 by Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0210, eff. April 2, 2015.Amended by: Acts 2015, 84th Leg., R.S., Ch. 837 (S.B. 200), Sec. 3.40(b)(3), eff. January 1, 2016.Acts 2015, 84th Leg., R.S., Ch. 946 (S.B. 277), Sec. 2.37(c)(3), eff. January 1, 2016.Acts 2021, 87th Leg., R.S., Ch. 811 (H.B. 2056), Sec. 24, eff. September 1, 2021.|
TX Health & Safety Code § 62.1571 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 62 - Child Health Plan for Certain Low-Income Children|Subchapter D. Child Health Plan|Section 62.1571. Telemedicine Medical Services and Telehealth Services

Text of section as amended by Acts 2021, 87th Leg., R.S., Ch. 624 (H.B. 4), Sec. 7For text of section as amended by Acts 2021, 87th Leg., R.S., Ch. 811 (H.B. 2056), Sec. 24, see other Sec. 62.1571.Sec. 62.1571.  TELEMEDICINE MEDICAL SERVICES AND TELEHEALTH SERVICES. (a) In providing covered benefits to a child, a health plan provider must permit benefits to be provided through telemedicine medical services and telehealth services in accordance with policies developed by the commission.(b)  The policies must provide for:(1)  the availability of covered benefits appropriately provided through telemedicine medical services or telehealth services that are comparable to the same types of covered benefits provided without the use of telemedicine medical services or telehealth services; and(2)  the availability of covered benefits for different services performed by multiple health care providers during a single session of telemedicine medical services or telehealth services, if the executive commissioner determines that delivery of the covered benefits in that manner is cost-effective in comparison to the costs that would be involved in obtaining the services from providers without the use of telemedicine medical services or telehealth services, including the costs of transportation and lodging and other direct costs.(d)  In this section, "telehealth service" and "telemedicine medical service" have the meanings assigned by Section 531.001, Government Code.|Added by Acts 2001, 77th Leg., ch. 1255, Sec. 4, eff. June 15, 2001.Redesignated and amended from Health and Safety Code, Section 62.157 by Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0210, eff. April 2, 2015.Amended by: Acts 2015, 84th Leg., R.S., Ch. 837 (S.B. 200), Sec. 3.40(b)(3), eff. January 1, 2016.Acts 2015, 84th Leg., R.S., Ch. 946 (S.B. 277), Sec. 2.37(c)(3), eff. January 1, 2016.Acts 2021, 87th Leg., R.S., Ch. 624 (H.B. 4), Sec. 7, eff. June 15, 2021.|
TX Health & Safety Code § 62.158 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 62 - Child Health Plan for Certain Low-Income Children|Subchapter D. Child Health Plan|Section 62.158. State Taxes

Sec. 62.158.  STATE TAXES.  The commission shall ensure that any experience rebate or profit-sharing for health plan providers under the child health plan is calculated by treating premium, maintenance, and other taxes under the Insurance Code and any other taxes payable to this state as allowable expenses for purposes of determining the amount of the experience rebate or profit-sharing.|Added by Acts 2003, 78th Leg., ch. 198, Sec. 2.53, eff. Sept. 1, 2003.|
TX Health & Safety Code § 62.159 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 62 - Child Health Plan for Certain Low-Income Children|Subchapter D. Child Health Plan|Section 62.159. Disease Management Services

Sec. 62.159.  DISEASE MANAGEMENT SERVICES.  (a)  In this section, "disease management services" means services to assist a child manage a disease or other chronic health condition, such as heart disease, diabetes, respiratory illness, end-stage renal disease, HIV infection, or AIDS, and with respect to which the executive commissioner identifies populations for which disease management would be cost-effective.(b)  The child health plan must provide disease management services or coverage for disease management services in the manner required by the executive commissioner, including:(1)  patient self-management education;(2)  provider education;(3)  evidence-based models and minimum standards of care;(4)  standardized protocols and participation criteria; and(5)  physician-directed or physician-supervised care.|Added by Acts 2003, 78th Leg., ch. 589, Sec. 1, eff. June 20, 2003.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0211, eff. April 2, 2015.|
TX Health & Safety Code § 65.001 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 65 - Prescription Drug Savings Program for Certain Uninsured Individuals|Subchapter A. General Provisions|Section 65.001. Definitions

Sec. 65.001.  DEFINITIONS.  In this chapter:(1)  "Enrollee" means an individual enrolled in the program.(2)  "Fund" means the trust fund established under Section 65.101.(3)  "Pharmacy benefit manager" has the meaning assigned by Section 4151.151, Insurance Code.(4)  "Prescription drug" has the meaning assigned by Section 551.003, Occupations Code.(5)  "Program" means the prescription drug savings program established under this chapter.(6)  "Uninsured individual" means an individual without health benefit plan coverage for a prescription drug benefit.|Added by Acts 2021, 87th Leg., R.S., Ch. 626 (H.B. 18), Sec. 2, eff. September 1, 2021.|
TX Health & Safety Code § 65.002 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 65 - Prescription Drug Savings Program for Certain Uninsured Individuals|Subchapter A. General Provisions|Section 65.002. Construction of Chapter; Purpose

Sec. 65.002.  CONSTRUCTION OF CHAPTER; PURPOSE.  (a)  This chapter does not establish an entitlement to assistance in obtaining benefits for uninsured individuals.(b)  The purpose of this chapter is to establish a program to provide uninsured individuals access to prescription drug benefits using money from the fund to pay an amount equal to the value of a prescription drug rebate at the point of sale and returning that rebate amount to the fund to ensure the amounts credited to the fund equal the amounts paid from the fund.(c)  This chapter does not expand the Medicaid program.|Added by Acts 2021, 87th Leg., R.S., Ch. 626 (H.B. 18), Sec. 2, eff. September 1, 2021.|
TX Health & Safety Code § 65.003 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 65 - Prescription Drug Savings Program for Certain Uninsured Individuals|Subchapter A. General Provisions|Section 65.003. Rules

Sec. 65.003.  RULES.  The executive commissioner shall adopt rules as necessary to implement this chapter.|Added by Acts 2021, 87th Leg., R.S., Ch. 626 (H.B. 18), Sec. 2, eff. September 1, 2021.|
TX Health & Safety Code § 65.051 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 65 - Prescription Drug Savings Program for Certain Uninsured Individuals|Subchapter B. Establishment and Administration of Prescription Drug Savings Program|Section 65.051. Establishment of Program

Sec. 65.051.  ESTABLISHMENT OF PROGRAM.  (a)  The commission shall develop and design a prescription drug savings program that partners with a pharmacy benefit manager to offer prescription drugs at a discounted rate to uninsured individuals.(b)  In developing and implementing the program, the commission shall ensure the program benefits do not include prescription drugs used for the elective termination of a pregnancy.(c)  The executive commissioner shall ensure the program is designed to provide the greatest possible value to uninsured individuals served by the program, while considering the adequacy of the prescription drug formulary, net costs of the drugs to enrollees, cost to the state, and other important factors determined by the commission.|Added by Acts 2021, 87th Leg., R.S., Ch. 626 (H.B. 18), Sec. 2, eff. September 1, 2021.|
TX Health & Safety Code § 65.052 (2021)
2021 Texas Statutes|Health and Safety Code|Title 2 - Health|Subtitle C - Programs Providing Health Care Benefits and Services|Chapter 65 - Prescription Drug Savings Program for Certain Uninsured Individuals|Subchapter B. Establishment and Administration of Prescription Drug Savings Program|Section 65.052. General Powers and Duties of Commission Related to Program

Sec. 65.052.  GENERAL POWERS AND DUTIES OF COMMISSION RELATED TO PROGRAM.  (a)  The commission shall oversee the implementation of the program and coordinate the activities of each state agency involved in that implementation.(b)  The commission shall design the program to be cost neutral by collecting prescription drug rebates after using money in the fund in amounts equal to the rebate amounts to purchase prescription drugs.(c)  The commission shall develop procedures for accepting applications for program enrollment, including a process to:(1)  determine eligibility, screening, and enrollment procedures that allow applicants to self attest to the extent authorized by federal law; and(2)  resolve disputes related to eligibility determinations.(d)  The commission shall publish on an Internet website all average consumer costs for each prescription drug available through the program.(e)  The commission and the contracted pharmacy benefit manager shall integrate manufacturer and other third-party patient assistance programs into the program to the extent feasible. A manufacturer or other third party may decline to link the manufacturer's or third party's patient assistance program to the program. The commission shall give preference to integrating patient assistance programs by listing information on those patient assistance programs in a central location on the Internet website described by Subsection (d) that directs patients to those patient assistance programs as appropriate.(f)  The commission shall ensure the program has access to an adequate pharmacy network and give preference to conducting the program using a state pharmaceutical assistance program.(g)  The commission is not required to enter into stand-alone contracts under this chapter. The commission may add the program, wholly or partly, to existing contracts to increase efficiency.|Added by Acts 2021, 87th Leg., R.S., Ch. 626 (H.B. 18), Sec. 2, eff. September 1, 2021.|