(a) This chapter implements the State Children's Health
Insurance Program (CHIP), authorized under the Texas Health and Safety
Code, Chapters 62 (relating to Child Health Plan for Certain Low-Income
Children) and 63 (relating to Health Benefits Plan For Certain Children),
in a manner that is timely, efficient, fair, and that promotes access
to quality and economical health and dental care for eligible children
and their families in Texas.
(b) This chapter also defines requirements for CHIP
managed care organizations (MCOs). An MCO must comply with this chapter
and the terms of its contract with HHSC.
(c) CHIP is a state-designed child health insurance
plan authorized under Title XXI of the federal Social Security Act
(42 U.S.C. §§1397aa, et seq.), and the Texas Health and
Safety Code, Chapters 62 (relating to Child Health Plan For Certain
Low-Income Children) and 63 (relating to Health Benefits Plan for
Certain Children), which provides access to low-cost preventive and
primary health and dental care to children, including children with
special health care needs, in certain low-income families of this
state.
(d) CHIP is administered, in part, in accordance with
the state plan for children's health insurance, filed by HHSC with
the federal Secretary of Health and Human Services, which describes
the general conditions under which joint federal state child health
insurance program funds will be administered in Texas.
(e) The rules in this chapter must be read in conjunction
with:
(1) federal and state statutes;
(2) rules relating to CHIP; and
(3) except where otherwise indicated, Texas Department
of Insurance rules regarding:
(A) regulation of health maintenance organizations
at 28 TAC Chapter 11 (relating to Health Maintenance Organizations);
and
(B) exclusive provider benefit plans at 28 TAC Chapter
3, Subchapter KK (relating to Exclusive Provider Benefit Plan).
(f) Nothing in this chapter shall be construed as providing
an individual with an entitlement to health or dental insurance benefits
or health care or to assistance in obtaining health insurance or health
benefits.
|
Source Note: The provisions of this §370.1 adopted to be effective April 4, 2001, 26 TexReg 2519; amended to be effective January 1, 2006, 30 TexReg 8666; amended to be effective March 1, 2012, 37 TexReg 1301; amended to be effective January 1, 2014, 38 TexReg 9477 |