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Are EPOs subject to prompt pay?

April 26, 2017epos pay prompt Subject

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Are EPOs subject to prompt pay?

1 Answer

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Exclusive Provider Plans, as described at 28 Texas Administrative Code §3.9201, are limited to the Statewide Rural Healthcare System, Medicaid and CHIP. The Statewide Rural Healthcare System was created to sponsor, arrange for or provide services in rural areas of Texas, and is not currently a licensed carrier. Medicaid and CHIP are exempt from the requirements of SB 418; however, they are subject to contractual payment requirements from Health and Human Services Commission.