Texas Administrative Code
Title 1 - ADMINISTRATION
Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
Chapter 353 - MEDICAID MANAGED CARE
Subchapter E - STANDARDS FOR MEDICAID MANAGED CARE
Section 353.405 - Marketing

Universal Citation: 1 TX Admin Code ยง 353.405

Current through Reg. 49, No. 38; September 20, 2024

(a) Managed care organizations (MCOs) must submit a marketing plan and all marketing materials to the Health and Human Services Commission (HHSC) for prior written approval.

(b) MCOs may present their marketing materials to eligible Medicaid clients through any method or media determined to be acceptable by HHSC. The media may include: written materials, such as brochures, posters, or fliers, which can be mailed directly to the client or left at HHSC eligibility offices; enrollment events; and public service announcements on radio.

(c) MCO enrollment or marketing representatives are required to complete HHSC's marketing orientation and training program prior to engaging in marketing activities on behalf of the MCO.

(d) Prohibited marketing practices.

(1) MCOs and providers must not conduct any direct contact marketing except through enrollment events or when assisting the MCO's current members with reapplication.

(2) MCOs and providers must not make any written or oral statement containing material misrepresentations of fact or law relating to their plan or the Medicaid managed care program.

(3) MCOs and providers must not make false, misleading or inaccurate statements relating to services or benefits, providers, or potential providers through their plan.

(4) MCOs and providers must not offer Medicaid recipients material or financial gain as an inducement for enrollment, unless an exception is made by HHSC.

(5) Marketing or enrollment practices of MCOs and providers must not discriminate against a client because of a client's race, creed, age, color, religion, national origin, ancestry, marital status, sexual orientation, physical or mental disability, health status, or existing need for medical care.

(e) MCO network providers must comply with the standards described in § 354.1452 of this title (relating to Provider Marketing).

(f) Nothing in this section prohibits a provider participating in the STAR+PLUS program from, as permitted under the provider's contract, engaging in a marketing activity, including any dissemination of material or other attempt to communicate, that is intended to educate a Medicaid client about available long-term care services and supports.

Disclaimer: These regulations may not be the most recent version. Texas may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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