2023 Texas Statutes › Health and Safety Code › Title 7 - Mental Health and Intellectual Disability › Subtitle A - Services for Persons With Mental Illness or an Intellectual Disability › Chapter 534 - Community Services › Subchapter C. Health Maintenance Organizations › Section 534.151. Health Maintenance Organization Certificate of Authority

Sec. 534.151.  HEALTH MAINTENANCE ORGANIZATION CERTIFICATE OF AUTHORITY.  (a)  One or more community centers may create or operate a nonprofit corporation pursuant to the laws of this state for the purpose of accepting capitated or other at-risk payment arrangements for the provision of services designated in a plan approved by each appropriate department under Subchapter A.
(b)  Before a nonprofit corporation organized or operating under Subsection (a) accepts or enters into any capitated or other at-risk payment arrangement for services designated in a plan approved by each appropriate department under Subchapter A, the nonprofit corporation must obtain the appropriate certificate of authority from the Texas Department of Insurance to operate as a health maintenance organization pursuant to Chapter 843, Insurance Code.
(c)  Before submitting any bids, a nonprofit corporation operating under this subchapter shall disclose in an open meeting the services to be provided by the community center through any capitated or other at-risk payment arrangement by the nonprofit corporation.  Notice of the meeting must be posted in accordance with Sections 551.041, 551.043, and 551.054, Government Code.  Each appropriate department shall verify that the services provided under any capitated or other at-risk payment arrangement are within the scope of services approved by each appropriate department in each community center's plan required under Subchapter A.
(d)  The board of the nonprofit corporation shall:
(1)  provide for public notice of the nonprofit corporation's intent to submit a bid to provide or arrange services through a capitated or other at-risk payment arrangement through placement as a board agenda item on the next regularly scheduled board meeting that allows at least 15 days' public review of the plan; and
(2)  provide an opportunity for public comment on the services to be provided through such arrangements and on the consideration of local input into the plan.
(e)  The nonprofit corporation shall provide:
(1)  public notice before verification and disclosure of services to be provided by the community center through any capitated or other at-risk payment arrangements by the nonprofit corporation;
(2)  an opportunity for public comment on the community center services within the capitated or other at-risk payment arrangements offered by the nonprofit corporation;
(3)  published summaries of all relevant documentation concerning community center services arranged through the nonprofit corporation, including summaries of any similar contracts the nonprofit corporation has entered into; and
(4)  public access and review of all relevant documentation.
(f)  A nonprofit corporation operating under this subchapter:
(1)  is subject to the requirements of Chapters 551 and 552, Government Code;
(2)  shall solicit public input on the operations of the nonprofit corporation and allow public access to information on the operations, including services, administration, governance, revenues, and expenses, on request unless disclosure is expressly prohibited by law or the information is confidential under law; and
(3)  shall publish an annual report detailing the services, administration, governance, revenues, and expenses of the nonprofit corporation, including the disposition of any excess revenues.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.1336, eff. April 2, 2015.