A member education program must present information in a manner
that is easy to understand. In addition to any requirements specified
in the contract between the managed care organization (MCO) and the
Health and Human Services Commission, a program must include, at minimum,
information on:
(1) a member's rights and responsibilities under the
Bill of Rights and the Bill of Responsibilities prescribed in Subchapter
C of this chapter (relating to Member Bill of Rights and Responsibilities);
(2) how to access dental services or health care services;
(3) how to access complaint and appeal procedures,
the member's right to request a fair hearing, and the process for
requesting a fair hearing;
(4) Medicaid policies, procedures, eligibility standards,
and benefits;
(5) the policies and procedures of the MCO; and
(6) the importance of prevention, early intervention,
and appropriate use of services.
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| Source Note: The provisions of this §353.104 adopted to be effective February 28, 1997, 22 TexReg 1799; amended to be effective August 10, 2005, 30 TexReg 4466; amended to be effective March 1, 2012, 37 TexReg 1283 |
