26 Tex. Admin. Code § 87.51 - Creation of the Program and Populations Served
(a) OMCAT is established by Texas Government
Code §
531.9912 in
accordance with Texas Government Code §
531.9932.
(b) OMCAT is responsible for assisting
persons who are experiencing barriers in the Medicaid application and
enrollment process and educating them so that they understand the concept of
managed care; understand their rights under Medicaid, including grievance and
appeal procedures; MCOs, health care providers, and any other appropriate
entity on and can advocate for themselves. OMCAT intervenes promptly with HHSC
Medicaid program staff, behalf of a person who has an urgent need for medical
services.
(c) As a part of the
support and information services, OMCAT is responsible for operating a
statewide toll-free assistance telephone number.
(d) In accordance with Texas Government Code
§
531.9932(e),
OMCAT is sufficiently independent from other aspects of Medicaid managed care
to represent the best interests of consumers in complaint resolution.
(e) OMCAT coordinates a network of entities
to provide support and information services to persons enrolled in or applying
for Medicaid who experience barriers to receiving health care
services.
Notes
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