PAYMENT BY GOVERNMENTAL OR PRIVATE ENTITY.
Tex. INS Code § 848.103.
in effect(a) A health care collaborative may:
(1) contract for and accept payments from a governmental or private entity for all or part of the cost of services provided or arranged for by the health care collaborative; and
(2) distribute payments to participating physicians and health care providers.
(b) Notwithstanding any other law, a health care collaborative that is in compliance with this code, including Chapters 841 , 842 , and 843 , as applicable, may contract for, accept, and distribute payments from governmental or private payors based on fee-for-service or alternative payment mechanisms, including:
(1) episode-based or condition-based bundled payments;
(2) capitation or global payments; or
(3) pay-for-performance or quality-based payments.
(c) Except as provided by Subsection (d), a health care collaborative may not contract for and accept payment from a governmental or private entity on a prepaid, capitation, or indemnity basis unless the health care collaborative is licensed as a health maintenance organization or insurer. The department shall review a health care collaborative's proposed payment methodology in contracts with governmental or private entities to ensure compliance with this section.
(d) A health care collaborative may contract for and accept compensation on a prepaid or capitation basis from a health maintenance organization or insurer.
Added by Acts 2011, 82nd Leg., 1st C.S., Ch. 7 (S.B. 7 ), Sec. 4.01, eff. September 28, 2011.