Texas § 540.0058 INFORMATION FOR FRAUD CONTROL.

Texas Statutes

§ 540.0058 — INFORMATION FOR FRAUD CONTROL.

Texas § 540.0058

Code GVGovernment Code

This text of Texas § 540.0058 (INFORMATION FOR FRAUD CONTROL.) 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. § 540.0058 (2026).

Text

Sec. 540.0058. INFORMATION FOR FRAUD CONTROL.

(a)Each Medicaid managed care organization shall submit at no cost to the commission and, on request, the office of the attorney general:

(1)a description of any financial or other business relationship between the organization and any subcontractor providing health care services under the contract between the organization and the commission;

(2)a copy of each type of contract between the organization and a subcontractor relating to the delivery of or payment for health care services;

(3)a description of the fraud control program any subcontractor that delivers health care services uses; and

(4)a description and breakdown of all funds paid to or by the organization, including a health maintenance organization, primary care case management

Free access — add to your briefcase to read the full text and ask questions with AI

Sec. 540.0058. INFORMATION FOR FRAUD CONTROL. (a) Each Medicaid managed care organization shall submit at no cost to the commission and, on request, the office of the attorney general:
(1) a description of any financial or other business relationship between the organization and any subcontractor providing health care services under the contract between the organization and the commission;
(2) a copy of each type of contract between the organization and a subcontractor relating to the delivery of or payment for health care services;
(3) a description of the fraud control program any subcontractor that delivers health care services uses; and
(4) a description and breakdown of all funds paid to or by the organization, including a health maintenance organization, primary care case management provider, pharmacy benefit manager, and exclusive provider organization, necessary for the commission to determine the actual cost of administering the Medicaid managed care plan.
(b) The information under this section must be:
(1) submitted in the form the commission or the office of the attorney general, as applicable, requires; and
(2) updated as the commission or the office of the attorney general, as applicable, requires.
(c) The commission's office of inspector general or the office of the attorney general, as applicable, shall review the information a Medicaid managed care organization submits under this section as appropriate in investigating fraud in the Medicaid managed care program.
(d) Information a Medicaid managed care organization submits to the commission or the office of the attorney general under Subsection (a)(1) is confidential and not subject to disclosure under Chapter 552 .