reglab/housing_qa huggingface dataset:
TX Govt Code § 531.0604 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 531 - Health and Human Services Commission|Subchapter B. Powers and Duties|Section 531.0604. Medically Dependent Children Program Eligibility Requirements; Nursing Facility Level of Care

Sec. 531.0604.  MEDICALLY DEPENDENT CHILDREN PROGRAM ELIGIBILITY REQUIREMENTS; NURSING FACILITY LEVEL OF CARE.  To the extent allowed by federal law, the commission may not require that a child reside in a nursing facility for an extended period of time to meet the nursing facility level of care required for the child to be determined eligible for the medically dependent children (MDCP) waiver program.|Added by Acts 2019, 86th Leg., R.S., Ch. 623 (S.B. 1207), Sec. 3(b), eff. September 1, 2019.|For expiration of this section, see Subsection (d).
TX Govt Code § 531.0605 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 531 - Health and Human Services Commission|Subchapter B. Powers and Duties|Section 531.0605. Advancing Care for Exceptional Kids Pilot Program

Sec. 531.0605.  ADVANCING CARE FOR EXCEPTIONAL KIDS PILOT PROGRAM.  (a)  The commission shall collaborate with the STAR Kids Managed Care Advisory Committee, Medicaid recipients, family members of children with complex medical conditions, children's health care advocates, Medicaid managed care organizations, and other stakeholders to develop and implement a pilot program that is substantially similar to the program described by Section 3, Medicaid Services Investment and Accountability Act of 2019 (Pub. L. No. 116-16), to provide coordinated care through a health home to children with complex medical conditions.(b)  The commission shall seek guidance from the Centers for Medicare and Medicaid Services and the United States Department of Health and Human Services regarding the design of the program and, based on the guidance, may actively seek and apply for federal funding to implement the program.(c)  Not later than December 31, 2024, the commission shall prepare and submit a report to the legislature that includes:(1)  a summary of the commission's implementation of the pilot program; and(2)  if the pilot program has been operating for a period sufficient to obtain necessary data, a summary of the commission's evaluation of the effect of the pilot program on the coordination of care for children with complex medical conditions and a recommendation as to whether the pilot program should be continued, expanded, or terminated.(d)  The pilot program terminates and this section expires September 1, 2025.|Added by Acts 2021, 87th Leg., R.S., Ch. 954 (S.B. 1648), Sec. 3, eff. September 1, 2021.|
TX Govt Code § 531.061 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 531 - Health and Human Services Commission|Subchapter B. Powers and Duties|Section 531.061. Participation by Fathers

Sec. 531.061.  PARTICIPATION BY FATHERS.  (a)  The commission and each health and human services agency shall periodically examine commission or agency policies and procedures to determine if the policies and procedures deter or encourage participation of fathers in commission or agency programs and services relating to children.(b)  Based on the examination required under Subsection (a), the commission and each health and human services agency shall modify policies and procedures as necessary to permit full participation of fathers in commission or agency programs and services relating to children in all appropriate circumstances.|Added by Acts 2001, 77th Leg., ch. 256, Sec. 2, eff. Sept. 1, 2001.  Renumbered from Government Code Sec. 531.055 by Acts 2003, 78th Leg., ch. 1275, Sec. 2(70), eff. Sept. 1, 2003.|
TX Govt Code § 531.062 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 531 - Health and Human Services Commission|Subchapter B. Powers and Duties|Section 531.062. Pilot Projects Relating to Technology Applications

Sec. 531.062.  PILOT PROJECTS RELATING TO TECHNOLOGY APPLICATIONS.  (a)  Notwithstanding any other law, the commission may establish one or more pilot projects through which reimbursement under Medicaid is made to demonstrate the applications of technology in providing services under that program.(b)  A pilot project established under this section may relate to providing rehabilitation services, services for the aging or persons with disabilities, or long-term care services, including community care services and support.(c)  Notwithstanding an eligibility requirement prescribed by any other law or rule, the commission may establish requirements for a person to receive services provided through a pilot project under this section.(d)  Receipt of services provided through a pilot project under this section does not entitle the recipient to other services under a government-funded health program.(e)  The commission may set a maximum enrollment limit for a pilot project established under this section.|Added by Acts 2001, 77th Leg., ch. 959, Sec. 1, eff. June 14, 2001.  Renumbered from Government Code Sec. 531.055 by Acts 2003, 78th Leg., ch. 1275, Sec. 2(71), eff. Sept. 1, 2003.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 2.099, eff. April 2, 2015.|
TX Govt Code § 531.066 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 531 - Health and Human Services Commission|Subchapter B. Powers and Duties|Section 531.066. Participation of Diagnostic Laboratory Service Providers in Certain Programs

Sec. 531.066.  PARTICIPATION OF DIAGNOSTIC LABORATORY SERVICE PROVIDERS IN CERTAIN PROGRAMS.  Notwithstanding any other law, a diagnostic laboratory may participate as an in-state provider under any program administered by a health and human services agency or the commission that involves diagnostic laboratory services, regardless of the location where any specific service is performed or where the laboratory's facilities are located if:(1)  the laboratory or an entity that is a parent, subsidiary, or other affiliate of the laboratory maintains diagnostic laboratory operations in this state;(2)  the laboratory and each entity that is a parent, subsidiary, or other affiliate of the laboratory, individually or collectively, employ at least 1,000 persons at places of employment located in this state; and(3)  the laboratory is otherwise qualified to provide the services under the program and is not prohibited from participating as a provider under any benefits programs administered by a health and human services agency or the commission based on conduct that constitutes fraud, waste, or abuse.|Added by Acts 2013, 83rd Leg., R.S., Ch. 789 (S.B. 1401), Sec. 1, eff. June 14, 2013.|
TX Govt Code § 531.067 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 531 - Health and Human Services Commission|Subchapter B. Powers and Duties|Section 531.067. Program to Improve and Monitor Certain Outcomes of Recipients Under Child Health Plan Program and Medicaid

Sec. 531.067.  PROGRAM TO IMPROVE AND MONITOR CERTAIN OUTCOMES OF RECIPIENTS UNDER CHILD HEALTH PLAN PROGRAM AND MEDICAID.  The commission may design and implement a program to improve and monitor clinical and functional outcomes of a recipient of services under Medicaid or the state child health plan program.  The program may use financial, clinical, and other criteria based on pharmacy, medical services, and other claims data related to Medicaid or the child health plan program. |Added by Acts 2003, 78th Leg., ch. 198, Sec. 2.08, eff. Sept. 1, 2003.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 2.102, eff. April 2, 2015.Acts 2015, 84th Leg., R.S., Ch. 837 (S.B. 200), Sec. 3.07, eff. January 1, 2016.Acts 2015, 84th Leg., R.S., Ch. 946 (S.B. 277), Sec. 2.07, eff. January 1, 2016.|
TX Govt Code § 531.069 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 531 - Health and Human Services Commission|Subchapter B. Powers and Duties|Section 531.069. Periodic Review of Vendor Drug Program

Sec. 531.069.  PERIODIC REVIEW OF VENDOR DRUG PROGRAM.  (a)  The commission shall periodically review all purchases made under the vendor drug program to determine the cost-effectiveness of including a component for prescription drug benefits in any capitation rate paid by the state under a Medicaid managed care program or the child health plan program.(b)  In making the determination required by Subsection (a), the commission shall consider the value of any prescription drug rebates received by the state.|Added by Acts 2003, 78th Leg., ch. 198, Sec. 2.10, eff. Sept. 1, 2003.|
TX Govt Code § 531.0693 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 531 - Health and Human Services Commission|Subchapter B. Powers and Duties|Section 531.0693. Prescription Drug Use and Expenditure Patterns

Sec. 531.0693.  PRESCRIPTION DRUG USE AND EXPENDITURE PATTERNS.  (a)  The commission shall monitor and analyze prescription drug use and expenditure patterns in Medicaid.  The commission shall identify the therapeutic prescription drug classes and individual prescription drugs that are most often prescribed to patients or that represent the greatest expenditures.(b)  The commission shall post the data determined by the commission under Subsection (a) on the commission's website and update the information on a quarterly basis.|Added by Acts 2009, 81st Leg., R.S., Ch. 1286 (H.B. 2030), Sec. 1, eff. September 1, 2009.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 2.105, eff. April 2, 2015.|
TX Govt Code § 531.0694 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 531 - Health and Human Services Commission|Subchapter B. Powers and Duties|Section 531.0694. Period of Validity for Prescription

Sec. 531.0694.  PERIOD OF VALIDITY FOR PRESCRIPTION.  In the rules and standards governing the vendor drug program, the executive commissioner, to the extent allowed by federal law and laws regulating the writing and dispensing of prescription medications, shall ensure that a prescription written by an authorized health care provider under Medicaid is valid for the lesser of the period for which the prescription is written or one year.  This section does not apply to a prescription for a controlled substance, as defined by Chapter 481, Health and Safety Code.|Added by Acts 2009, 81st Leg., R.S., Ch. 1286 (H.B. 2030), Sec. 1, eff. September 1, 2009.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 2.106, eff. April 2, 2015.|
TX Govt Code § 531.0696 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 531 - Health and Human Services Commission|Subchapter B. Powers and Duties|Section 531.0696. Considerations in Awarding Certain Contracts

Sec. 531.0696.  CONSIDERATIONS IN AWARDING CERTAIN CONTRACTS.  The commission may not contract with a managed care organization, including a health maintenance organization, or a pharmacy benefit manager if, in the preceding three years, the organization or pharmacy benefit manager, in connection with a bid, proposal, or contract with the commission, was subject to a final judgment by a court of competent jurisdiction resulting in a conviction for a criminal offense under state or federal law:(1)  related to the delivery of an item or service;(2)  related to neglect or abuse of patients in connection with the delivery of an item or service;(3)  consisting of a felony related to fraud, theft, embezzlement, breach of fiduciary responsibility, or other financial misconduct; or(4)  resulting in a penalty or fine in the amount of $500,000 or more in a state or federal administrative proceeding.|Added by Acts 2011, 82nd Leg., 1st C.S., Ch. 7 (S.B. 7), Sec. 1.15, eff. September 28, 2011.|
TX Govt Code § 531.0697 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 531 - Health and Human Services Commission|Subchapter B. Powers and Duties|Section 531.0697. Prior Approval and Provider Access to Certain Communications With Certain Recipients

Sec. 531.0697.  PRIOR APPROVAL AND PROVIDER ACCESS TO CERTAIN COMMUNICATIONS WITH CERTAIN RECIPIENTS.  (a)  This section applies to:(1)  the vendor drug program for Medicaid and the child health plan program;(2)  the kidney health care program;(3)  the children with special health care needs program; and(4)  any other state program administered by the commission that provides prescription drug benefits.(b)  A managed care organization, including a health maintenance organization, or a pharmacy benefit manager, that administers claims for prescription drug benefits under a program to which this section applies shall, at least 10 days before the date the organization or pharmacy benefit manager intends to deliver a communication to recipients collectively under a program:(1)  submit a copy of the communication to the commission for approval; and(2)  if applicable, allow the pharmacy providers of recipients who are to receive the communication access to the communication.|Added by Acts 2011, 82nd Leg., 1st C.S., Ch. 7 (S.B. 7), Sec. 1.15, eff. September 28, 2011.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 2.107, eff. April 2, 2015.|
TX Govt Code § 531.0701 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 531 - Health and Human Services Commission|Subchapter B. Powers and Duties|Section 531.0701. Value-Based Arrangements

Sec. 531.0701.  VALUE-BASED ARRANGEMENTS.  (a)  In this section, "manufacturer" has the meaning assigned by Section 531.070.(b)  Subject to Section 531.071, the commission may enter into a value-based arrangement for the Medicaid vendor drug program by written agreement with a manufacturer based on outcome data or other metrics to which this state and the manufacturer agree in writing.  The value-based arrangement may include a rebate, a discount, a price reduction, a contribution, risk sharing, a reimbursement, payment deferral or installment payments, a guarantee, patient care, shared savings payments, withholds, a bonus, or any other thing of value.|Added by Acts 2019, 86th Leg., R.S., Ch. 272 (S.B. 1780), Sec. 1, eff. September 1, 2019.|
TX Govt Code § 531.071 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 531 - Health and Human Services Commission|Subchapter B. Powers and Duties|Section 531.071. Confidentiality of Information Regarding Drug Rebates, Pricing, and Negotiations

Sec. 531.071.  CONFIDENTIALITY OF INFORMATION REGARDING DRUG REBATES, PRICING, AND NEGOTIATIONS.  (a)  Notwithstanding any other state law, information obtained or maintained by the commission regarding prescription drug rebate negotiations or a supplemental Medicaid or other rebate agreement, including trade secrets, rebate amount, rebate percentage, and manufacturer or labeler pricing, is confidential and not subject to disclosure under Chapter 552.(b)  Information that is confidential under Subsection (a) includes information described by Subsection (a) that is obtained or maintained by the commission in connection with the Medicaid vendor drug program, the child health plan program, the kidney health care program, the children with special health care needs program, or another state program administered by the commission or a health and human services agency.(c)  General information about the aggregate costs of different classes of drugs is not confidential under Subsection (a), except that a drug name or information that could reveal a drug name is confidential.(d)  Information about whether the commission and a manufacturer or labeler reached or did not reach a supplemental rebate agreement under Section 531.070 for a particular drug is not confidential under Subsection (a).|Added by Acts 2003, 78th Leg., ch. 198, Sec. 2.12, eff. Sept. 1, 2003.Amended by: Acts 2009, 81st Leg., R.S., Ch. 1286 (H.B. 2030), Sec. 2, eff. September 1, 2009.Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 2.109, eff. April 2, 2015.|
TX Govt Code § 531.0737 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 531 - Health and Human Services Commission|Subchapter B. Powers and Duties|Section 531.0737. Drug Utilization Review Board: Conflicts of Interest

Sec. 531.0737.  DRUG UTILIZATION REVIEW BOARD:  CONFLICTS OF INTEREST.  (a)  A voting member of the Drug Utilization Review Board may not have a contractual relationship, ownership interest, or other conflict of interest with a pharmaceutical manufacturer or labeler or with an entity engaged by the commission to assist in the development of the preferred drug lists or in the administration of the Medicaid Drug Utilization Review Program.(b)  The executive commissioner may implement this section by adopting rules that identify prohibited relationships and conflicts or requiring the board to develop a conflict-of-interest policy that applies to the board.|Added by Acts 2009, 81st Leg., R.S., Ch. 1286 (H.B. 2030), Sec. 1, eff. September 1, 2009.Redesignated and amended from Government Code, Section 531.0692 by Acts 2015, 84th Leg., R.S., Ch. 837 (S.B. 200), Sec. 3.08(c), and Ch. 946 (S.B. 277), Sec. 2.08(c), eff. January 1, 2016.|For expiration of this section, see Subsection (b).
TX Govt Code § 531.0738 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 531 - Health and Human Services Commission|Subchapter B. Powers and Duties|Section 531.0738. Application for Funding to Implement Model of Care for Certain Medicaid Recipients

Sec. 531.0738.  APPLICATION FOR FUNDING TO IMPLEMENT MODEL OF CARE FOR CERTAIN MEDICAID RECIPIENTS.  (a)  The commission shall apply to the Centers for Medicare and Medicaid Services to receive any federal money available to implement a model of care that improves the quality and accessibility of care for:(1)  pregnant women with opioid use disorder enrolled in Medicaid during the prenatal and postpartum periods; and(2)  their children after birth.(b)  This section expires September 1, 2021.|Added by Acts 2019, 86th Leg., R.S., Ch. 601 (S.B. 750), Sec. 1, eff. June 10, 2019.|
TX Govt Code § 531.0741 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 531 - Health and Human Services Commission|Subchapter B. Powers and Duties|Section 531.0741. Publication of Information Regarding Commission Decisions on Preferred Drug List Placement

Sec. 531.0741.  PUBLICATION OF INFORMATION REGARDING COMMISSION DECISIONS ON PREFERRED DRUG LIST PLACEMENT.  The commission shall publish on the commission's Internet website any decisions on preferred drug list placement, including:(1)  a list of drugs reviewed and the commission's decision for or against placement on a preferred drug list of each drug reviewed;(2)  for each recommendation, whether a supplemental rebate agreement or a program benefit agreement was reached under Section 531.070; and(3)  the rationale for any departure from a recommendation of the Drug Utilization Review Board under Section 531.0736.|Added by Acts 2009, 81st Leg., R.S., Ch. 1286 (H.B. 2030), Sec. 6, eff. September 1, 2009.Amended by: Acts 2015, 84th Leg., R.S., Ch. 837 (S.B. 200), Sec. 3.08(f), eff. January 1, 2016.Acts 2015, 84th Leg., R.S., Ch. 946 (S.B. 277), Sec. 2.08(f), eff. January 1, 2016.|
TX Govt Code § 531.075 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 531 - Health and Human Services Commission|Subchapter B. Powers and Duties|Section 531.075. Prior Authorization for High-Cost Medical Services

Sec. 531.075.  PRIOR AUTHORIZATION FOR HIGH-COST MEDICAL SERVICES.  The commission may evaluate and implement, as appropriate, procedures, policies, and methodologies to require prior authorization for high-cost medical services and procedures and may contract with qualified service providers or organizations to perform those functions.  Any such program shall recognize any prohibitions in state or federal law on limits in the amount, duration, or scope of medically necessary services for children on Medicaid.|Added by Acts 2003, 78th Leg., ch. 198, Sec. 2.16, eff. Sept. 1, 2003.|
TX Govt Code § 531.076 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 531 - Health and Human Services Commission|Subchapter B. Powers and Duties|Section 531.076. Review of Prior Authorization and Utilization Review Processes

Sec. 531.076.  REVIEW OF PRIOR AUTHORIZATION AND UTILIZATION REVIEW PROCESSES.  (a)  The commission shall periodically review in accordance with an established schedule the prior authorization and utilization review processes within the Medicaid fee-for-service delivery model to determine if those processes need modification to reduce authorizations of unnecessary services and inappropriate use of services.  The commission shall also monitor the processes described in this subsection for anomalies and, on identification of an anomaly in a process, shall review the process for modification earlier than scheduled.(b)  The commission shall monitor Medicaid managed care organizations to ensure that the organizations are using prior authorization and utilization review processes to reduce authorizations of unnecessary services and inappropriate use of services.|Added by Acts 2013, 83rd Leg., R.S., Ch. 1311 (S.B. 8), Sec. 4, eff. September 1, 2013.|
TX Govt Code § 531.077 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 531 - Health and Human Services Commission|Subchapter B. Powers and Duties|Section 531.077. Recovery of Certain Assistance

Sec. 531.077.  RECOVERY OF CERTAIN ASSISTANCE.  (a)  The executive commissioner shall ensure that Medicaid implements 42 U.S.C. Section 1396p(b)(1).(b)  The Medicaid account is an account in the general revenue fund.  Any funds recovered by implementing 42 U.S.C. Section 1396p(b)(1) shall be deposited in the Medicaid account.  Money in the account may be appropriated only to fund long-term care, including community-based care and facility-based care.|Added by Acts 2003, 78th Leg., ch. 198, Sec. 2.17, eff. Sept. 1, 2003.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 2.112, eff. April 2, 2015.Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 2.113, eff. April 2, 2015.|