Texas § 540.0055 MARKETING GUIDELINES.

Texas Statutes

§ 540.0055 — MARKETING GUIDELINES.

Texas § 540.0055

Code GVGovernment Code

This text of Texas § 540.0055 (MARKETING GUIDELINES.) is published on Counsel Stack Legal Research, covering Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Tex. Government Code Code Ann. § 540.0055 (2026).

Text

Sec. 540.0055. MARKETING GUIDELINES.

(a)The commission shall establish marketing guidelines for Medicaid managed care organizations, including guidelines that prohibit:

(1)door-to-door marketing to a recipient by a Medicaid managed care organization or the organization's agent;

(2)using marketing materials with inaccurate or misleading information;

(3)making a misrepresentation to a recipient or provider;

(4)offering a recipient a material or financial incentive to choose a Medicaid managed care plan, other than a nominal gift or free health screening the commission approves that the Medicaid managed care organization offers to all recipients regardless of whether the recipients enroll in the plan;

(5)using a marketing agent who is paid solely by commission; and

(6)face-to-face mark

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Sec. 540.0055. MARKETING GUIDELINES. (a) The commission shall establish marketing guidelines for Medicaid managed care organizations, including guidelines that prohibit:
(1) door-to-door marketing to a recipient by a Medicaid managed care organization or the organization's agent;
(2) using marketing materials with inaccurate or misleading information;
(3) making a misrepresentation to a recipient or provider;
(4) offering a recipient a material or financial incentive to choose a Medicaid managed care plan, other than a nominal gift or free health screening the commission approves that the Medicaid managed care organization offers to all recipients regardless of whether the recipients enroll in the plan;
(5) using a marketing agent who is paid solely by commission; and
(6) face-to-face marketing at a public assistance office by a Medicaid managed care organization or the organization's agent.
(b) This section does not prohibit:
(1) distributing approved marketing materials at a public assistance office; or
(2) providing information directly to a recipient under marketing guidelines the commission establishes.
(c) The marketing guidelines the commission establishes under this section may not prohibit a Medicaid managed care organization from:
(1) informing an individual, including a current or former recipient, about the availability of qualified health plans offered through an exchange, as the terms "exchange" and "qualified health plan" are defined by 45 C.F.R. Section 155.20; or
(2) advertising a Medicare Advantage plan or related benefit offered under Part C of Title XVIII of the Social Security Act (42 U.S.C. Section 1395w-21 et seq.) at a community enrollment or other event.
(d) The marketing guidelines the commission establishes under this section must require that a Medicaid managed care organization that informs an individual about the availability of qualified health plans offered through an exchange, as the terms "exchange" and "qualified health plan" are defined by 45 C.F.R. Section 155.20, also inform the individual about the potential deductibles, copayments, and other cost-sharing requirements under a qualified health plan. A Medicaid managed care organization informing an individual about the availability of qualified health plans offered through the exchange or an affiliate of the organization may not offer the individual material or financial gain as an actual or implied incentive for enrolling in a qualified health plan.

Legislative History

Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611 ), Sec. 1.01, eff. April 1, 2025. Amended by: Acts 2025, 89th Leg., R.S., Ch. 355 (S.B. 963 ), Sec. 1, eff. September 1, 2025.