Texas § 540A.0001 DEFINITIONS.

Texas Statutes

§ 540A.0001 — DEFINITIONS.

Texas § 540A.0001

Code GVGovernment Code

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Bluebook

Tex. Government Code Code Ann. § 540A.0001 (2026).

Text

Sec. 540A.0001. DEFINITIONS. In this chapter:

(1)Notwithstanding Section 521.0001 (2), "commission" means the Health and Human Services Commission or an agency operating part of the Medicaid managed care program, as appropriate.

(2)"Managed care plan" means a plan under which a person undertakes to provide, arrange for, pay for, or reimburse any part of the cost of any health care service. A part of the plan must consist of arranging for or providing health care services as distinguished from indemnification against the cost of those services on a prepaid basis through insurance or otherwise. The term includes a primary care case management provider network. The term does not include a plan that indemnifies a person for the cost of health care services through insurance.

(3)"Managed tra

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Sec. 540A.0001. DEFINITIONS. In this chapter:
(1) Notwithstanding Section 521.0001 (2), "commission" means the Health and Human Services Commission or an agency operating part of the Medicaid managed care program, as appropriate.
(2) "Managed care plan" means a plan under which a person undertakes to provide, arrange for, pay for, or reimburse any part of the cost of any health care service. A part of the plan must consist of arranging for or providing health care services as distinguished from indemnification against the cost of those services on a prepaid basis through insurance or otherwise. The term includes a primary care case management provider network. The term does not include a plan that indemnifies a person for the cost of health care services through insurance.
(3) "Managed transportation organization" means:
(A) a rural or urban transit district created under Chapter 458 , Transportation Code;
(B) a public transportation provider as defined by Section 461.002 , Transportation Code;
(C) a regional contracted broker as defined by Section 526.0351 ;
(D) a local private transportation provider the commission approves to provide Medicaid nonemergency medical transportation services; or
(E) any other entity the commission determines meets the requirements of Subchapter B.
(4) "Medical transportation program" has the meaning assigned by Section 526.0351 .
(5) "Nonemergency transportation service" has the meaning assigned by Section 526.0351 .
(6) "Nonmedical transportation service" means:
(A) curb-to-curb transportation to or from a medically necessary, nonemergency covered health care service in a standard passenger vehicle that is scheduled not more than 48 hours before the transportation occurs, that is provided to a recipient enrolled in a Medicaid managed care plan offered by a Medicaid managed care organization, and that the organization determines meets the level of care that is medically appropriate for the recipient, including transportation related to:
(i) discharging a recipient from a health care facility;
(ii) receiving urgent care; and
(iii) obtaining pharmacy services and prescription drugs; and
(B) any other transportation to or from a medically necessary, nonemergency covered health care service the commission considers appropriate to be provided by a transportation vendor, as determined by commission rule or policy.
(7) "Recipient" means a Medicaid recipient.
(8) "Transportation network company" has the meaning assigned by Section 2402.001 , Occupations Code.
(9) "Transportation vendor" means an entity, including a transportation network company, that contracts with a Medicaid managed care organization to provide nonmedical transportation services.
SUBCHAPTER B. MEDICAL TRANSPORTATION PROGRAM SERVICES THROUGH MANAGED TRANSPORTATION DELIVERY MODEL