reglab/housing_qa huggingface dataset:
TX Govt Code § 533.082 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 533 - Medicaid Managed Care Program|Subchapter E. Pilot Program to Increase Incentive-Based Provider Payments|Section 533.082. Pilot Program to Increase Incentive-Based Provider Payments

Sec. 533.082.  PILOT PROGRAM TO INCREASE INCENTIVE-BASED PROVIDER PAYMENTS.  The commission shall develop a pilot program to increase the use and effectiveness of incentive-based provider payments by managed care organizations providing services under the Medicaid managed care program.  The commission and the managed care organizations providing those services in at least one managed care service delivery area shall work with health care providers and professional associations composed of health care providers to develop common payment incentive methodologies for the pilot program that:(1)  are structured to reward appropriate, quality care;(2)  align outcomes of the pilot program with the commission's Medicaid managed care quality-based payment programs;(3)  are not intended to supplant existing incentive-based contracts between the managed care organizations and providers;(4)  are structured to encourage formal arrangements among providers to work together to provide better patient care;(5)  are adopted by all managed care organizations providing services under the Medicaid managed care program through the same managed care service delivery model so that similar incentive methodologies apply to all participating providers under the same model; and(6)  are voluntarily agreed to by the participating providers.|Added by Acts 2015, 84th Leg., R.S., Ch. 837 (S.B. 200), Sec. 2.25(a), eff. September 1, 2015.|
TX Govt Code § 533.083 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 533 - Medicaid Managed Care Program|Subchapter E. Pilot Program to Increase Incentive-Based Provider Payments|Section 533.083. Assessment and Implementation of Pilot Program Findings

Sec. 533.083.  ASSESSMENT AND IMPLEMENTATION OF PILOT PROGRAM FINDINGS.  Not later than September 1, 2018, and notwithstanding any other law, the commission shall:(1)  based on the results of the pilot program, identify which types of incentive-based provider payment goals and outcome measures are most appropriate for statewide implementation and the services that can be provided using those goals and outcome measures; and(2)  require that a managed care organization that has contracted with the commission to provide health care services to recipients implement the payment goals and outcome measures identified under Subdivision (1).|Added by Acts 2015, 84th Leg., R.S., Ch. 837 (S.B. 200), Sec. 2.25(a), eff. September 1, 2015.|
TX Govt Code § 533.084 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 533 - Medicaid Managed Care Program|Subchapter E. Pilot Program to Increase Incentive-Based Provider Payments|Section 533.084. Expiration

Sec. 533.084.  EXPIRATION.  Sections 533.081 and 533.082 and this section expire September 1, 2018.|Added by Acts 2015, 84th Leg., R.S., Ch. 837 (S.B. 200), Sec. 2.25(a), eff. September 1, 2015.|
TX Govt Code § 534.002 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 534 - System Redesign for Delivery of Medicaid Acute Care Services and Long-Term Services and Supports to Persons With an Intellectual or Developmental Disability|Subchapter A. General Provisions|Section 534.002. Conflict With Other Law

Sec. 534.002.  CONFLICT WITH OTHER LAW.  To the extent of a conflict between a provision of this chapter and another state law, the provision of this chapter controls.|Added by Acts 2013, 83rd Leg., R.S., Ch. 1310 (S.B. 7), Sec. 1.01, eff. September 1, 2013.|
TX Govt Code § 534.051 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 534 - System Redesign for Delivery of Medicaid Acute Care Services and Long-Term Services and Supports to Persons With an Intellectual or Developmental Disability|Subchapter B. Acute Care Services and Long-Term Services and Supports System|Section 534.051. Acute Care Services and Long-Term Services and Supports System for Individuals With an Intellectual or Developmental Disability

Sec. 534.051.  ACUTE CARE SERVICES AND LONG-TERM SERVICES AND SUPPORTS SYSTEM FOR INDIVIDUALS WITH AN INTELLECTUAL OR DEVELOPMENTAL DISABILITY.  In accordance with this chapter, the commission shall design and implement an acute care services and long-term services and supports system for individuals with an intellectual or developmental disability that supports the following goals:(1)  provide Medicaid services to more individuals in a cost-efficient manner by providing the type and amount of services most appropriate to the individuals' needs and preferences in the most integrated and least restrictive setting;(2)  improve individuals' access to services and supports by ensuring that the individuals receive information about all available programs and services, including employment and least restrictive housing assistance, and how to apply for the programs and services;(3)  improve the assessment of individuals' needs and available supports, including the assessment of individuals' functional needs;(4)  promote person-centered planning, self-direction, self-determination, community inclusion, and customized, integrated, competitive employment;(5)  promote individualized budgeting based on an assessment of an individual's needs and person-centered planning;(6)  promote integrated service coordination of acute care services and long-term services and supports;(7)  improve acute care and long-term services and supports outcomes, including reducing unnecessary institutionalization and potentially preventable events;(8)  promote high-quality care;(9)  provide fair hearing and appeals processes in accordance with applicable federal law;(10)  ensure the availability of a local safety net provider and local safety net services;(11)  promote independent service coordination and independent ombudsmen services; and(12)  ensure that individuals with the most significant needs are appropriately served in the community and that processes are in place to prevent inappropriate institutionalization of individuals.|Added by Acts 2013, 83rd Leg., R.S., Ch. 1310 (S.B. 7), Sec. 1.01, eff. September 1, 2013.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 2.242, eff. April 2, 2015.Acts 2019, 86th Leg., R.S., Ch. 1330 (H.B. 4533), Sec. 7, eff. September 1, 2019.|
TX Govt Code § 534.052 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 534 - System Redesign for Delivery of Medicaid Acute Care Services and Long-Term Services and Supports to Persons With an Intellectual or Developmental Disability|Subchapter B. Acute Care Services and Long-Term Services and Supports System|Section 534.052. Implementation of System Redesign

Sec. 534.052.  IMPLEMENTATION OF SYSTEM REDESIGN.  The commission shall, in consultation and collaboration with the advisory committee, implement the acute care services and long-term services and supports system for individuals with an intellectual or developmental disability in the manner and in the stages described in this chapter.|Added by Acts 2013, 83rd Leg., R.S., Ch. 1310 (S.B. 7), Sec. 1.01, eff. September 1, 2013.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 2.243, eff. April 2, 2015.Acts 2019, 86th Leg., R.S., Ch. 1330 (H.B. 4533), Sec. 7, eff. September 1, 2019.|For expiration of this section, see Subsection (g).
TX Govt Code § 534.054 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 534 - System Redesign for Delivery of Medicaid Acute Care Services and Long-Term Services and Supports to Persons With an Intellectual or Developmental Disability|Subchapter B. Acute Care Services and Long-Term Services and Supports System|Section 534.054. Annual Report on Implementation

Sec. 534.054.  ANNUAL REPORT ON IMPLEMENTATION.  (a)  Not later than September 30 of each year, the commission, in consultation and collaboration with the advisory committee, shall prepare and submit a report to the legislature that must include:(1)  an assessment of the implementation of the system required by this chapter, including appropriate information regarding the provision of acute care services and long-term services and supports to individuals with an intellectual or developmental disability under Medicaid as described by this chapter;(2)  recommendations regarding implementation of and improvements to the system redesign, including recommendations regarding appropriate statutory changes to facilitate the implementation; and(3)  an assessment of the effect of the system on the following:(A)  access to long-term services and supports;(B)  the quality of acute care services and long-term services and supports;(C)  meaningful outcomes for Medicaid recipients using person-centered planning, individualized budgeting, and self-determination, including a person's inclusion in the community;(D)  the integration of service coordination of acute care services and long-term services and supports;(E)  the efficiency and use of funding;(F)  the placement of individuals in housing that is the least restrictive setting appropriate to an individual's needs;(G)  employment assistance and customized, integrated, competitive employment options; and(H)  the number and types of fair hearing and appeals processes in accordance with applicable federal law.(b)  This section expires on the second anniversary of the date the commission completes implementation of the transition required under Section 534.202.|Added by Acts 2013, 83rd Leg., R.S., Ch. 1310 (S.B. 7), Sec. 1.01, eff. September 1, 2013.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 2.245, eff. April 2, 2015.Acts 2015, 84th Leg., R.S., Ch. 1117 (H.B. 3523), Sec. 4, eff. June 19, 2015.Acts 2019, 86th Leg., R.S., Ch. 1330 (H.B. 4533), Sec. 10, eff. September 1, 2019.|
TX Govt Code § 534.101 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 534 - System Redesign for Delivery of Medicaid Acute Care Services and Long-Term Services and Supports to Persons With an Intellectual or Developmental Disability|Subchapter C. Stage One: Pilot Program for Improving Service Delivery Models|Section 534.101. Definitions

Sec. 534.101.  DEFINITIONS.  In this subchapter:(1)  "Capitation" means a method of compensating a provider on a monthly basis for providing or coordinating the provision of a defined set of services and supports that is based on a predetermined payment per services recipient.(2)  "Pilot program" means the pilot program established under this subchapter.(3)  "Pilot program workgroup" means the pilot program workgroup established under Section 534.1015.|Added by Acts 2013, 83rd Leg., R.S., Ch. 1310 (S.B. 7), Sec. 1.01, eff. September 1, 2013.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 2.247, eff. April 2, 2015.Acts 2019, 86th Leg., R.S., Ch. 1330 (H.B. 4533), Sec. 12, eff. September 1, 2019.|
TX Govt Code § 534.1015 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 534 - System Redesign for Delivery of Medicaid Acute Care Services and Long-Term Services and Supports to Persons With an Intellectual or Developmental Disability|Subchapter C. Stage One: Pilot Program for Improving Service Delivery Models|Section 534.1015. Pilot Program Workgroup

Sec. 534.1015.  PILOT PROGRAM WORKGROUP.  (a)  The executive commissioner, in consultation with the advisory committee, shall establish a pilot program workgroup to provide assistance in developing and advice concerning the operation of the pilot program.(b)  The pilot program workgroup is composed of:(1)  representatives of the advisory committee;(2)  stakeholders representing individuals with an intellectual or developmental disability;(3)  stakeholders representing individuals with similar functional needs as those individuals described by Subdivision (2); and(4)  representatives of managed care organizations that contract with the commission to provide services under the STAR+PLUS Medicaid managed care program.(c)  Chapter 2110 applies to the pilot program workgroup.|Added by Acts 2019, 86th Leg., R.S., Ch. 1330 (H.B. 4533), Sec. 13, eff. September 1, 2019.|
TX Govt Code § 534.102 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 534 - System Redesign for Delivery of Medicaid Acute Care Services and Long-Term Services and Supports to Persons With an Intellectual or Developmental Disability|Subchapter C. Stage One: Pilot Program for Improving Service Delivery Models|Section 534.102. Pilot Program to Test Person-Centered Managed Care Strategies and Improvements Based on Capitation

Sec. 534.102.  PILOT PROGRAM TO TEST PERSON-CENTERED MANAGED CARE STRATEGIES AND IMPROVEMENTS BASED ON CAPITATION.  The commission, in consultation and collaboration with the advisory committee and pilot program workgroup, shall develop and implement a pilot program in accordance with this subchapter to test, through the STAR+PLUS Medicaid managed care program, the delivery of long-term services and supports to individuals participating in the pilot program.|Added by Acts 2013, 83rd Leg., R.S., Ch. 1310 (S.B. 7), Sec. 1.01, eff. September 1, 2013.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 2.248, eff. April 2, 2015.Acts 2019, 86th Leg., R.S., Ch. 1330 (H.B. 4533), Sec. 14, eff. September 1, 2019.|
TX Govt Code § 534.103 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 534 - System Redesign for Delivery of Medicaid Acute Care Services and Long-Term Services and Supports to Persons With an Intellectual or Developmental Disability|Subchapter C. Stage One: Pilot Program for Improving Service Delivery Models|Section 534.103. Stakeholder Input

Sec. 534.103.  STAKEHOLDER INPUT.  As part of developing and implementing the pilot program, the commission, in consultation and collaboration with the advisory committee and pilot program workgroup, shall develop a process to receive and evaluate:(1)  input from statewide stakeholders and stakeholders from a STAR+PLUS Medicaid managed care service area in which the pilot program will be implemented; and(2)  other evaluations and data.|Added by Acts 2013, 83rd Leg., R.S., Ch. 1310 (S.B. 7), Sec. 1.01, eff. September 1, 2013.Amended by: Acts 2019, 86th Leg., R.S., Ch. 1330 (H.B. 4533), Sec. 14, eff. September 1, 2019.|
TX Govt Code § 534.1035 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 534 - System Redesign for Delivery of Medicaid Acute Care Services and Long-Term Services and Supports to Persons With an Intellectual or Developmental Disability|Subchapter C. Stage One: Pilot Program for Improving Service Delivery Models|Section 534.1035. Managed Care Organization Selection

Sec. 534.1035.  MANAGED CARE ORGANIZATION SELECTION.  (a)  The commission, in consultation and collaboration with the advisory committee and pilot program workgroup, shall develop criteria regarding the selection of a managed care organization to participate in the pilot program.(b)  The commission shall select and contract with not more than two managed care organizations that contract with the commission to provide services under the STAR+PLUS Medicaid managed care program to participate in the pilot program.|Added by Acts 2019, 86th Leg., R.S., Ch. 1330 (H.B. 4533), Sec. 15, eff. September 1, 2019.|
TX Govt Code § 534.105 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 534 - System Redesign for Delivery of Medicaid Acute Care Services and Long-Term Services and Supports to Persons With an Intellectual or Developmental Disability|Subchapter C. Stage One: Pilot Program for Improving Service Delivery Models|Section 534.105. Pilot Program: Measurable Goals

Sec. 534.105.  PILOT PROGRAM: MEASURABLE GOALS.  (a)  The commission, in consultation and collaboration with the advisory committee and pilot program workgroup and using national core indicators, the National Quality Forum long-term services and supports measures, and other appropriate Consumer Assessment of Healthcare Providers and Systems measures, shall identify measurable goals to be achieved by the pilot program.(b)  The commission, in consultation and collaboration with the advisory committee and pilot program workgroup, shall develop specific strategies and performance measures for achieving the identified goals.  A proposed strategy may be evidence-based if there is an evidence-based strategy available for meeting the pilot program's goals.(c)  The commission, in consultation and collaboration with the advisory committee and pilot program workgroup, shall ensure that mechanisms to report, track, and assess specific strategies and performance measures for achieving the identified goals are established before implementing the pilot program.|Added by Acts 2013, 83rd Leg., R.S., Ch. 1310 (S.B. 7), Sec. 1.01, eff. September 1, 2013.Amended by: Acts 2019, 86th Leg., R.S., Ch. 1330 (H.B. 4533), Sec. 18, eff. September 1, 2019.|
TX Govt Code § 534.106 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 534 - System Redesign for Delivery of Medicaid Acute Care Services and Long-Term Services and Supports to Persons With an Intellectual or Developmental Disability|Subchapter C. Stage One: Pilot Program for Improving Service Delivery Models|Section 534.106. Implementation, Location, and Duration

Sec. 534.106.  IMPLEMENTATION, LOCATION, AND DURATION.  (a)  The commission shall implement the pilot program on September 1, 2023.(b)  The pilot program shall operate for at least 24 months.(c)  The pilot program shall be conducted in a STAR+PLUS Medicaid managed care service area selected by the commission.|Added by Acts 2013, 83rd Leg., R.S., Ch. 1310 (S.B. 7), Sec. 1.01, eff. September 1, 2013.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1117 (H.B. 3523), Sec. 6, eff. June 19, 2015.Acts 2019, 86th Leg., R.S., Ch. 1330 (H.B. 4533), Sec. 18, eff. September 1, 2019.|
TX Govt Code § 534.107 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 534 - System Redesign for Delivery of Medicaid Acute Care Services and Long-Term Services and Supports to Persons With an Intellectual or Developmental Disability|Subchapter C. Stage One: Pilot Program for Improving Service Delivery Models|Section 534.107. Commission Responsibilities

Sec. 534.107.  COMMISSION RESPONSIBILITIES.  (a)  The commission shall require that a managed care organization participating in the pilot program:(1)  ensures that individuals participating in the pilot program have a choice among acute care and comprehensive long-term services and supports providers and service delivery options, including the consumer direction model;(2)  demonstrates to the commission's satisfaction that the organization's network of acute care, long-term services and supports, and comprehensive long-term services and supports providers have experience and expertise in providing services for individuals with an intellectual or developmental disability and individuals with similar functional needs;(3)  has a process for preventing inappropriate institutionalizations of individuals; and(4)  ensures the timely initiation and consistent provision of services in accordance with an individual's person-centered plan.(b)  For the duration of the pilot program, the commission shall ensure that comprehensive long-term services and supports providers are considered significant traditional providers and included in the provider network of a managed care organization participating in the pilot program.|Added by Acts 2013, 83rd Leg., R.S., Ch. 1310 (S.B. 7), Sec. 1.01, eff. September 1, 2013.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 2.250, eff. April 2, 2015.Acts 2019, 86th Leg., R.S., Ch. 1330 (H.B. 4533), Sec. 18, eff. September 1, 2019.|
TX Govt Code § 534.108 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 534 - System Redesign for Delivery of Medicaid Acute Care Services and Long-Term Services and Supports to Persons With an Intellectual or Developmental Disability|Subchapter C. Stage One: Pilot Program for Improving Service Delivery Models|Section 534.108. Pilot Program Information

Sec. 534.108.  PILOT PROGRAM INFORMATION.  (a)  The commission, in consultation and collaboration with the advisory committee and pilot program workgroup, shall determine which information will be collected from a managed care organization participating in the pilot program to use in conducting the evaluation and preparing the report under Section 534.112.(b)  For the duration of the pilot program, a managed care organization participating in the pilot program shall submit to the commission and the advisory committee quarterly reports on the services provided to each pilot program participant that include information on:(1)  the level of each requested service and the authorization and utilization rates for those services;(2)  timelines of:(A)  the delivery of each requested service;(B)  authorization of each requested service;(C)  the initiation of each requested service; and(D)  each unplanned break in the delivery of requested services and the duration of the break;(3)  the number of pilot program participants using employment assistance and supported employment services;(4)  the number of service denials and fair hearings and the dispositions of fair hearings;(5)  the number of complaints and inquiries received by the managed care organization and the outcome of each complaint; and(6)  the number of pilot program participants who choose the consumer direction model and the reasons why other participants did not choose the consumer direction model.(c)  The commission shall ensure that the mechanisms to report and track the information and data required by this section are established before implementing the pilot program.|Added by Acts 2013, 83rd Leg., R.S., Ch. 1310 (S.B. 7), Sec. 1.01, eff. September 1, 2013.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1117 (H.B. 3523), Sec. 7, eff. June 19, 2015.Acts 2019, 86th Leg., R.S., Ch. 1330 (H.B. 4533), Sec. 18, eff. September 1, 2019.|
TX Govt Code § 534.109 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 534 - System Redesign for Delivery of Medicaid Acute Care Services and Long-Term Services and Supports to Persons With an Intellectual or Developmental Disability|Subchapter C. Stage One: Pilot Program for Improving Service Delivery Models|Section 534.109. Person-Centered Planning

Sec. 534.109.  PERSON-CENTERED PLANNING.  The commission, in consultation and collaboration with the advisory committee and pilot program workgroup, shall ensure that each individual who receives services and supports under Medicaid through the pilot program, or the individual's legally authorized representative, has access to a comprehensive, facilitated, person-centered plan that identifies outcomes for the individual and drives the development of the individualized budget.  The consumer direction model must be an available option for individuals to achieve self-determination, choice, and control.|Added by Acts 2013, 83rd Leg., R.S., Ch. 1310 (S.B. 7), Sec. 1.01, eff. September 1, 2013.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 2.251, eff. April 2, 2015.Acts 2019, 86th Leg., R.S., Ch. 1330 (H.B. 4533), Sec. 18, eff. September 1, 2019.|