190.019 Medicaid and Medicaid Managed Care


Medicaid and Medicaid Managed Care: The Texas Medical Association (1) advocates for Medicaid managed care reform including administrative simplification, protection of the Primary Care Case Management model, and continuation of the moratorium on new Medicaid managed care service areas until such time that current operational, administrative, and payment problems can be resolved; and (2) continues to explore development of alternative care delivery models for Medicaid managed care that incorporate the following principles: (a) patient access to a medical home; (b) access to prescription drugs; (c) evidence-based health and disease management for high-risk, chronically ill, and disabled patients; (d) a flexible delivery system design to accommodate Texas' diverse care delivery systems and geography; (e) physician-driven, clinically appropriate quality and utilization management systems; (f) simplified administration and claims payment processes; and (g) reasonable payment that reflects the rapidly increasing practice costs of physicians who care for this patient population (Amended CSE Rep. 3-I-00; amended CSE Rep. 1-A-10).

Last Updated On

October 07, 2016