28 Tex. Admin. Code § 10.40 - Management Contracts
(a) A network may
not enter into a contract with another entity for management services, or
modify a previously approved management contract, unless the proposed contract
or modification is first filed with the department and approved by the
Commissioner in accordance with Insurance Code §
1305.102, concerning
Management Contracts.
(b) For
purposes of this chapter, management services include management control and
decision-making, and contracting on behalf of the network under a delegation of
management authority, power of attorney, or other arrangement.
(c) If a person is serving as both a
management contractor or a third party to which the network delegates a
function and as an agent of the health care provider, the contract between the
management contractor or third party and the health care provider must comply
with Insurance Code §
1305.153, concerning
Provider Reimbursement.
(d) A
management contractor or a third party that is also serving as an agent for one
or more health care providers in the certified network must meet the disclosure
requirements with the certified network under Insurance Code §
1305.153.
Notes
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