Texas Administrative Code
Title 1 - ADMINISTRATION
Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
Chapter 354 - MEDICAID HEALTH SERVICES
Subchapter A - PURCHASED HEALTH SERVICES
Division 26 - COORDINATED CARE
Section 354.1351 - Coordinated Care Pilot Project

Universal Citation: 1 TX Admin Code ยง 354.1351

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

(a) The Texas Department of Health is conducting a coordinated care pilot project in response to the Human Resources Code, § RSA 32.041, which was enacted by the Texas Legislature in 1991. The objectives of the project are to ensure adequate access to primary health care, prevent unnecessary utilization of health care resources, reduce inappropriate utilization of health care resources, and enhance the cost effectiveness of the Medicaid program for aid to families with dependent children (AFDC) and AFDC-related clients.

(b) All eligible AFDC and AFDC-related Medicaid clients in the counties specified in subsection (c) of this section must participate in the project. These clients:

(1) will receive the current services available under the Texas Medicaid program, except that the existing three-prescription drug limit for clients over the age of 21 is removed; and

(2) must select an individual primary care provider (PCP) who will manage their medical care.

(c) Clients in Travis County begin participation in the project August 1, 1993, and clients in the tri-county area of Chambers, Jefferson, and Galveston begin participation December 1, 1993. Clients in these counties will continue to participate in the project for a period of two years.

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