reglab/housing_qa huggingface dataset:
TX Govt Code § 535.105 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 535 - Provision of Human Services and Other Social Services Through Faith- and Community-Based Organizations|Subchapter C. Renewing Our Communities Account|Section 535.105. Administration of Account Funds

Sec. 535.105.  ADMINISTRATION OF ACCOUNT FUNDS.  If under Section 535.104 the commission contracts with or awards a grant to the State Commission on National and Community Service, that entity:(1)  may award grants from funds appropriated from the account to:(A)  faith- and community-based organizations that provide charitable services to persons in this state for capacity-building purposes; and(B)  local governmental entities to provide seed money for local offices for faith- and community-based initiatives; and(2)  shall monitor performance and outcome measures for persons to whom that entity awards grants using the measures established by the commission under Section 535.104(a)(6).|Added by Acts 2009, 81st Leg., R.S., Ch. 259 (H.B. 492), Sec. 1(a), eff. May 30, 2009.|
TX Govt Code § 535.106 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 535 - Provision of Human Services and Other Social Services Through Faith- and Community-Based Organizations|Subchapter C. Renewing Our Communities Account|Section 535.106. Reports and Public Information

Sec. 535.106.  REPORTS AND PUBLIC INFORMATION.  (a)  The commission shall provide a link on the commission's Internet website to the Internet website of the State Commission on National and Community Service if the commission contracts with or awards a grant to that entity under Section 535.104.  The entity's Internet website must provide:(1)  a list of the names of each person to whom the entity awarded a grant from money appropriated from the account and the amount and purpose of the grant; and(2)  information regarding the methods by which the public may request information about those grants.(b)  If awarded a contract or grant under Section 535.104, the State Commission on National and Community Service must provide to the commission periodic reports on a schedule determined by the executive commissioner.  The schedule of periodic reports must include an annual report that includes:(1)  a specific accounting with respect to the use by that entity of money appropriated from the account, including the names of persons to whom grants have been awarded and the purposes of those grants; and(2)  a summary of the efforts of the faith- and community-based liaisons designated under Section 535.051 to comply with the duties imposed by and the purposes of Sections 535.052 and 535.053.(c)  The commission shall post the annual report made under Subsection (b) on the commission's Internet website and shall provide copies of the report to the governor, the lieutenant governor, and the members of the legislature.|Added by Acts 2009, 81st Leg., R.S., Ch. 259 (H.B. 492), Sec. 1(a), eff. May 30, 2009.|
TX Govt Code § 536.005 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 536 - Medicaid and the Child Health Plan Program: Quality-Based Outcomes and Payments|Subchapter A. General Provisions|Section 536.005. Conversion of Payment Methodology

Sec. 536.005.  CONVERSION OF PAYMENT METHODOLOGY.  (a)  To the extent possible, the commission shall convert hospital reimbursement systems under the child health plan program and Medicaid to a diagnosis-related groups (DRG) methodology that will allow the commission to more accurately classify specific patient populations and account for severity of patient illness and mortality risk.(b)  Subsection (a) does not authorize the commission to direct a managed care organization to compensate physicians and other health care providers providing services under the organization's managed care plan based on a diagnosis-related groups (DRG) methodology.(c)  Notwithstanding Subsection (a) and to the extent possible, the commission shall convert outpatient hospital reimbursement systems under the child health plan program and Medicaid to an appropriate prospective payment system that will allow the commission to:(1)  more accurately classify the full range of outpatient service episodes;(2)  more accurately account for the intensity of services provided; and(3)  motivate outpatient service providers to increase efficiency and effectiveness.|Added by Acts 2011, 82nd Leg., 1st C.S., Ch. 7 (S.B. 7), Sec. 1.12(a), eff. September 28, 2011.Amended by: Acts 2013, 83rd Leg., R.S., Ch. 1310 (S.B. 7), Sec. 4.09, eff. September 1, 2013.Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 2.263, eff. April 2, 2015.|
TX Govt Code § 536.006 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 536 - Medicaid and the Child Health Plan Program: Quality-Based Outcomes and Payments|Subchapter A. General Provisions|Section 536.006. Transparency

Sec. 536.006.  TRANSPARENCY.  (a)  The commission shall:(1)  ensure transparency in the development and establishment of:(A)  quality-based payment and reimbursement systems under Section 536.004 and Subchapters B, C, and D, including the development of outcome and process measures under Section 536.003; and(B)  quality-based payment initiatives under Subchapter E, including the development of quality of care and cost-efficiency benchmarks under Section 536.204(a) and efficiency performance standards under Section 536.204(b);(2)  develop guidelines establishing procedures for providing notice and information to, and receiving input from, managed care organizations, health care providers, including physicians and experts in the various medical specialty fields, and other stakeholders, as appropriate, for purposes of developing and establishing the quality-based payment and reimbursement systems and initiatives described under Subdivision (1);(3)  in developing and establishing the quality-based payment and reimbursement systems and initiatives described under Subdivision (1), consider that as the performance of a managed care organization or physician or other health care provider improves with respect to an outcome or process measure, quality of care and cost-efficiency benchmark, or efficiency performance standard, as applicable, there will be a diminishing rate of improved performance over time; and(4)  develop web-based capability to provide managed care organizations and health care providers with data on their clinical and utilization performance, including comparisons to peer organizations and providers located in this state and in the provider's respective region.(b)  The web-based capability required by Subsection (a)(4) must support the requirements of the electronic health information exchange system under Sections 531.907 through 531.909.|Added by Acts 2011, 82nd Leg., 1st C.S., Ch. 7 (S.B. 7), Sec. 1.12(a), eff. September 28, 2011.Amended by: Acts 2013, 83rd Leg., R.S., Ch. 1310 (S.B. 7), Sec. 4.10, eff. September 1, 2013.Acts 2015, 84th Leg., R.S., Ch. 837 (S.B. 200), Sec. 3.24, eff. January 1, 2016.Acts 2015, 84th Leg., R.S., Ch. 946 (S.B. 277), Sec. 2.24, eff. January 1, 2016.|
TX Govt Code § 536.007 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 536 - Medicaid and the Child Health Plan Program: Quality-Based Outcomes and Payments|Subchapter A. General Provisions|Section 536.007. Periodic Evaluation

Sec. 536.007.  PERIODIC EVALUATION.  (a)  At least once each two-year period, the commission shall evaluate the outcomes and cost-effectiveness of any quality-based payment system or other payment initiative implemented under this chapter.(b)  Repealed by Acts 2015, 84th Leg., R.S., Ch. 946, Sec. 2.37(b)(24), and Ch. 837, Sec. 3.40(a)(23), eff. January 1, 2016.|Added by Acts 2011, 82nd Leg., 1st C.S., Ch. 7 (S.B. 7), Sec. 1.12(a), eff. September 28, 2011.Amended by: Acts 2015, 84th Leg., R.S., Ch. 837 (S.B. 200), Sec. 3.40(a)(23), eff. January 1, 2016.Acts 2015, 84th Leg., R.S., Ch. 946 (S.B. 277), Sec. 2.37(b)(24), eff. January 1, 2016.|
TX Govt Code § 536.008 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 536 - Medicaid and the Child Health Plan Program: Quality-Based Outcomes and Payments|Subchapter A. General Provisions|Section 536.008. Annual Report

Sec. 536.008.  ANNUAL REPORT.  (a)  The commission shall submit to the legislature and make available to the public an annual report regarding:(1)  the quality-based outcome and process measures developed under Section 536.003, including measures based on each potentially preventable event; and(2)  the progress of the implementation of quality-based payment systems and other payment initiatives implemented under this chapter.(b)  As appropriate, the commission shall report outcome and process measures under Subsection (a)(1) by:(1)  geographic location, which may require reporting by county, health care service region, or other appropriately defined geographic area;(2)  recipient population or eligibility group served;(3)  type of health care provider, such as acute care or long-term care provider;(4)  number of recipients who relocated to a community-based setting from a less integrated setting;(5)  quality-based payment system; and(6)  service delivery model.(c)  The report required under this section may not identify specific health care providers.|Added by Acts 2011, 82nd Leg., 1st C.S., Ch. 7 (S.B. 7), Sec. 1.12(a), eff. September 28, 2011.Amended by: Acts 2013, 83rd Leg., R.S., Ch. 1310 (S.B. 7), Sec. 4.11, eff. September 1, 2013.|
TX Govt Code § 536.051 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 536 - Medicaid and the Child Health Plan Program: Quality-Based Outcomes and Payments|Subchapter B. Quality-Based Payments Relating to Managed Care Organizations|Section 536.051. Development of Quality-Based Premium Payments; Performance Reporting

Sec. 536.051.  DEVELOPMENT OF QUALITY-BASED PREMIUM PAYMENTS; PERFORMANCE REPORTING.  (a)  Subject to Section 1903(m)(2)(A), Social Security Act (42 U.S.C. Section 1396b(m)(2)(A)), and other applicable federal law, the commission shall base a percentage of the premiums paid to a managed care organization participating in the child health plan program or Medicaid on the organization's performance with respect to outcome and process measures developed under Section 536.003 that address potentially preventable events.  The percentage of the premiums paid may increase each year.(b)  The commission shall make available information relating to the performance of a managed care organization with respect to outcome and process measures under this subchapter to child health plan program enrollees and Medicaid recipients before those enrollees and recipients choose their managed care plans.|Added by Acts 2011, 82nd Leg., 1st C.S., Ch. 7 (S.B. 7), Sec. 1.12(a), eff. September 28, 2011.Amended by: Acts 2013, 83rd Leg., R.S., Ch. 1310 (S.B. 7), Sec. 4.12, eff. September 1, 2013.Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 2.264, eff. April 2, 2015.|
TX Govt Code § 536.052 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 536 - Medicaid and the Child Health Plan Program: Quality-Based Outcomes and Payments|Subchapter B. Quality-Based Payments Relating to Managed Care Organizations|Section 536.052. Payment and Contract Award Incentives for Managed Care Organizations

Sec. 536.052.  PAYMENT AND CONTRACT AWARD INCENTIVES FOR MANAGED CARE ORGANIZATIONS.  (a)  The commission may allow a managed care organization participating in the child health plan program or Medicaid increased flexibility to implement quality initiatives in a managed care plan offered by the organization, including flexibility with respect to financial arrangements, in order to:(1)  achieve high-quality, cost-effective health care;(2)  increase the use of high-quality, cost-effective delivery models;(3)  reduce the incidence of unnecessary institutionalization and potentially preventable events; and(4)  increase the use of alternative payment systems, including shared savings models, in collaboration with physicians and other health care providers.(b)  The commission shall develop quality of care and cost-efficiency benchmarks, including benchmarks based on a managed care organization's performance with respect to reducing potentially preventable events and containing the growth rate of health care costs.(c)  The commission may include in a contract between a managed care organization and the commission financial incentives that are based on the organization's successful implementation of quality initiatives under Subsection (a) or success in achieving quality of care and cost-efficiency benchmarks under Subsection (b).(d)  In awarding contracts to managed care organizations under the child health plan program and Medicaid, the commission shall, in addition to considerations under Section 533.003 of this code and Section 62.155, Health and Safety Code, give preference to an organization that offers a managed care plan that successfully implements quality initiatives under Subsection (a) as determined by the commission based on data or other evidence provided by the organization or meets quality of care and cost-efficiency benchmarks under Subsection (b).(e)  The commission may implement financial incentives under this section only if implementing the incentives would be cost-effective.|Added by Acts 2011, 82nd Leg., 1st C.S., Ch. 7 (S.B. 7), Sec. 1.12(a), eff. September 28, 2011.Amended by: Acts 2013, 83rd Leg., R.S., Ch. 1310 (S.B. 7), Sec. 4.13, eff. September 1, 2013.Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 2.265, eff. April 2, 2015.Acts 2015, 84th Leg., R.S., Ch. 837 (S.B. 200), Sec. 3.25, eff. January 1, 2016.Acts 2015, 84th Leg., R.S., Ch. 946 (S.B. 277), Sec. 2.25, eff. January 1, 2016.|
TX Govt Code § 536.101 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 536 - Medicaid and the Child Health Plan Program: Quality-Based Outcomes and Payments|Subchapter C. Quality-Based Health Home Payment Systems|Section 536.101. Definitions

Sec. 536.101.  DEFINITIONS.  In this subchapter:(1)  "Health home" means a primary care provider practice or, if appropriate, a specialty care provider practice, incorporating several features, including comprehensive care coordination, family-centered care, and data management, that are focused on improving outcome-based quality of care and increasing patient and provider satisfaction under the child health plan program and Medicaid.(2)  "Participating enrollee" means a child health plan program enrollee or Medicaid recipient who has a health home.|Added by Acts 2011, 82nd Leg., 1st C.S., Ch. 7 (S.B. 7), Sec. 1.12(a), eff. September 28, 2011.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 2.266, eff. April 2, 2015.|
TX Govt Code § 536.102 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 536 - Medicaid and the Child Health Plan Program: Quality-Based Outcomes and Payments|Subchapter C. Quality-Based Health Home Payment Systems|Section 536.102. Quality-Based Health Home Payments

Sec. 536.102.  QUALITY-BASED HEALTH HOME PAYMENTS.  (a)  Subject to this subchapter, the commission may develop and implement quality-based payment systems for health homes designed to improve quality of care and reduce the provision of unnecessary medical services.  A quality-based payment system developed under this section must:(1)  base payments made to a participating enrollee's health home on quality and efficiency measures that may include measurable wellness and prevention criteria and use of evidence-based best practices, sharing a portion of any realized cost savings achieved by the health home, and ensuring quality of care outcomes, including a reduction in potentially preventable events; and(2)  allow for the examination of measurable wellness and prevention criteria, use of evidence-based best practices, and quality of care outcomes based on the type of primary or specialty care provider practice.(b)  The commission may develop a quality-based payment system for health homes under this subchapter only if implementing the system would be feasible and cost-effective.|Added by Acts 2011, 82nd Leg., 1st C.S., Ch. 7 (S.B. 7), Sec. 1.12(a), eff. September 28, 2011.Amended by: Acts 2015, 84th Leg., R.S., Ch. 837 (S.B. 200), Sec. 3.26, eff. January 1, 2016.Acts 2015, 84th Leg., R.S., Ch. 946 (S.B. 277), Sec. 2.26, eff. January 1, 2016.|
TX Govt Code § 536.103 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 536 - Medicaid and the Child Health Plan Program: Quality-Based Outcomes and Payments|Subchapter C. Quality-Based Health Home Payment Systems|Section 536.103. Provider Eligibility

Sec. 536.103.  PROVIDER ELIGIBILITY.  To be eligible to receive reimbursement under a quality-based payment system under this subchapter, a health home provider must:(1)  provide participating enrollees, directly or indirectly, with access to health care services outside of regular business hours;(2)  educate participating enrollees about the availability of health care services outside of regular business hours; and(3)  provide evidence satisfactory to the commission that the provider meets the requirement of Subdivision (1).|Added by Acts 2011, 82nd Leg., 1st C.S., Ch. 7 (S.B. 7), Sec. 1.12(a), eff. September 28, 2011.|
TX Govt Code § 536.151 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 536 - Medicaid and the Child Health Plan Program: Quality-Based Outcomes and Payments|Subchapter D. Quality-Based Hospital Reimbursement System|Section 536.151. Collection and Reporting of Certain Information

Sec. 536.151.  COLLECTION AND REPORTING OF CERTAIN INFORMATION.  (a)  The executive commissioner shall adopt rules for identifying:(1)  potentially preventable admissions and readmissions of child health plan program enrollees and Medicaid recipients, including preventable admissions to long-term care facilities;(2)  potentially preventable ancillary services provided to or ordered for child health plan program enrollees and Medicaid recipients;(3)  potentially preventable emergency room visits by child health plan program enrollees and Medicaid recipients; and(4)  potentially preventable complications experienced by child health plan program enrollees and Medicaid recipients.(a-1)  The commission shall collect data from hospitals on present-on-admission indicators for purposes of this section.(b)  The commission shall establish a program to provide a confidential report to each hospital in this state that participates in the child health plan program or Medicaid regarding the hospital's performance with respect to each potentially preventable event described under Subsection (a).  To the extent possible, a report provided under this section should include all potentially preventable events across all child health plan program and Medicaid payment systems.  A hospital shall distribute the information contained in the report to physicians and other health care providers providing services at the hospital.(c)  Except as provided by Subsection (d), a report provided to a hospital under this section is confidential and is not subject to Chapter 552.(d)  The commission may release the information in the report described by Subsection (b):(1)  not earlier than one year after the date the report is submitted to the hospital; and(2)  only after deleting any data that relates to a hospital's performance with respect to particular diagnosis-related groups or individual patients.|Added by Acts 2009, 81st Leg., R.S., Ch. 1120 (H.B. 1218), Sec. 1, eff. September 1, 2009.Transferred, redesignated and amended from Government Code, Section 531.913 by Acts 2011, 82nd Leg., 1st C.S., Ch. 7 (S.B. 7), Sec. 1.12(a), eff. September 28, 2011.Amended by: Acts 2013, 83rd Leg., R.S., Ch. 1310 (S.B. 7), Sec. 4.14, eff. September 1, 2013.Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 2.267, eff. April 2, 2015.|
TX Govt Code § 536.152 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 536 - Medicaid and the Child Health Plan Program: Quality-Based Outcomes and Payments|Subchapter D. Quality-Based Hospital Reimbursement System|Section 536.152. Reimbursement Adjustments

Sec. 536.152.  REIMBURSEMENT ADJUSTMENTS.  (a)  Subject to Subsection (b), using the data collected under Section 536.151 and the diagnosis-related groups (DRG) methodology implemented under Section 536.005, if applicable, the commission shall to the extent feasible adjust child health plan and Medicaid reimbursements to hospitals, including payments made under the disproportionate share hospitals and upper payment limit supplemental payment programs, based on the hospital's performance with respect to exceeding, or failing to achieve, outcome and process measures developed under Section 536.003 that address the rates of potentially preventable readmissions and potentially preventable complications.(b)  The commission must provide the report required under Section 536.151(b) to a hospital at least one year before the commission adjusts child health plan and Medicaid reimbursements to the hospital under this section.|Added by Acts 2011, 82nd Leg., 1st C.S., Ch. 7 (S.B. 7), Sec. 1.12(a), eff. September 28, 2011.Amended by: Acts 2013, 83rd Leg., R.S., Ch. 1310 (S.B. 7), Sec. 4.15, eff. September 1, 2013.Acts 2015, 84th Leg., R.S., Ch. 837 (S.B. 200), Sec. 3.27, eff. January 1, 2016.Acts 2015, 84th Leg., R.S., Ch. 946 (S.B. 277), Sec. 2.27, eff. January 1, 2016.|
TX Govt Code § 536.201 (2021)
2021 Texas Statutes|Government Code|Title 4 - Executive Branch|Subtitle I - Health and Human Services|Chapter 536 - Medicaid and the Child Health Plan Program: Quality-Based Outcomes and Payments|Subchapter E. Quality-Based Payment Initiatives|Section 536.201. Definition

Sec. 536.201.  DEFINITION.  In this subchapter, "payment initiative" means a quality-based payment initiative established under this subchapter.|Added by Acts 2011, 82nd Leg., 1st C.S., Ch. 7 (S.B. 7), Sec. 1.12(a), eff. September 28, 2011.|