Texas § 540.0154 PERFORMANCE AUDIT SELECTION PROCESS AND FOLLOW-UP.

Texas Statutes

§ 540.0154 — PERFORMANCE AUDIT SELECTION PROCESS AND FOLLOW-UP.

Texas § 540.0154

Code GVGovernment Code

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Bluebook

Tex. Government Code Code Ann. § 540.0154 (2026).

Text

Sec. 540.0154. PERFORMANCE AUDIT SELECTION PROCESS AND FOLLOW-UP.

(a)To improve the commission's processes for performance audits of managed care organizations, the commission shall:

(1)document the process by which the commission selects organizations to audit;

(2)include previous audit coverage as a risk factor in selecting organizations to audit; and

(3)prioritize the highest risk organizations to audit.

(b)To verify that managed care organizations correct negative performance audit findings, the commission shall:

(1)establish a process to:

(A)document how the commission follows up on those findings; and

(B)verify that organizations implement performance audit recommendations; and

(2)establish and implement policies and procedures to:

(A)determine under what circumstances the

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Sec. 540.0154. PERFORMANCE AUDIT SELECTION PROCESS AND FOLLOW-UP. (a) To improve the commission's processes for performance audits of managed care organizations, the commission shall:
(1) document the process by which the commission selects organizations to audit;
(2) include previous audit coverage as a risk factor in selecting organizations to audit; and
(3) prioritize the highest risk organizations to audit.
(b) To verify that managed care organizations correct negative performance audit findings, the commission shall:
(1) establish a process to:
(A) document how the commission follows up on those findings; and
(B) verify that organizations implement performance audit recommendations; and
(2) establish and implement policies and procedures to:
(A) determine under what circumstances the commission must issue a corrective action plan to an organization based on a performance audit; and
(B) follow up on the organization's implementation of the plan.