Texas Government Code §533.0072 requires the Texas Health and Human Services Commission to post information regarding contract enforcement actions taken against Medicaid managed care organizations. Enforcement actions include monetary and other forms of remedies, such as:
- Payment of liquidated damages
- Requiring corrective action plans
- Suspending all or part of new member enrollments
- Suspending or terminating all or part of the contract
Enforcement actions are posted quarterly and contain the following information:
- Name and address of the managed care organization
- A description of the contractual obligation the managed care organization failed to meet
- The date of determination of noncompliance
- The date the sanction or remedy was imposed
- The maximum sanction or remedy that may be imposed under the contract for the violation
- The actual sanction or remedy imposed against the managed care organization
MCO Sanctions
- Aetna (Excel)
- Amerigroup Texas, Inc. (Excel)
- Blue Cross Blue Shield (Excel)
- Community First Health Plans, Inc. (Excel)
- Community Health Choice, Inc. (Excel)
- Cook Children's Health Plan (Excel)
- Dell Children's Health Plan (Excel)
- DentaQuest (Excel)
- Driscoll Health Plan (Excel)
- El Paso First (Excel)
- Firstcare (Excel)
- HealthSpring (Excel)
- MCNA (Excel)
- Molina Healthcare of Texas (Excel)
- Parkland Community Health Plan (Excel)
- Scott & White (Excel)
- Superior Health Plan (Excel)
- Texas Children's Health Plan (Excel)
- United Dental (Excel)
- United Healthcare (Excel)
Managed Care Corrective Action Plans
SFY 2023
- May 2023 (PDF)
- April 2023 (PDF)
- March 2023 (PDF)
- February 2023 (PDF)
- January 2023 (PDF)
- December 2022 (PDF)
- November 2022 (PDF)
- October 2022 (PDF)
- September 2022 (PDF)
SFY 2022
- August 2022 (PDF)
- July 2022 (PDF)
- June 2022 (PDF)
- May 2022 (PDF)
- April 2022 (PDF)
- March 2022 (PDF)
- February 2022 (PDF)
- January 2022 (PDF)
- December 2021 (PDF)
- November 2021 (PDF)
- October 2021 (PDF)
- September 2021 (PDF)
SFY 2021
- August 2021 (PDF)
- July 2021 (PDF)
- June 2021 (PDF)
- May 2021 (PDF)
- April 2021 (PDF)
- March 2021 (PDF)
- February 2021 (PDF)
- January 2021 (PDF)
- December 2020 (PDF)
- November 2020 (PDF)
- October 2020 (PDF)
- September 2020 (PDF)
An incentive and disincentive system was created as a response to the Frew v. Smith Corrective Action Order: Managed Care and can be viewed at Medicaid Managed Care Incentives and Disincentives.