Friday, October 14, 2016

Provider Marketing Guidelines

Originally published by Jerri Lynn Ward, J.D..

Provider Marketing Guidelines

Purpose

The purpose of the Texas Provider Marketing Guidelines is to provide guidance to the State of Texas Medicaid fee-for-service, Medicaid Managed Care, Children’s Health Insurance Program (CHIP), Children’s Medicaid Dental, and CHIP Dental Providers, referred to as Medicaid, on permissible and prohibited provider marketing.

The information provided is not intended to be comprehensive, or to identify all applicable state and federal laws and regulations. Providers remain responsible for and must comply with all applicable requirements of state and federal laws and regulations.

Applicable Legal Authorities

  • Texas Health and Human Services Commission (HHSC) Office of Inspector General (OIG) Special Advisory Bulletin: Offering Gifts and Other Inducements to Beneficiaries, August 2002
  • Texas HHSC OIG Special Advisory Bulletin: Offering Gifts and Other Inducements to Beneficiaries, March 6, 2013
  • Senate Bill 8, 83rd Legislature, Regular Session, 2013
  • 1 Texas Administrative Code §353.405
  • 1 Texas Administrative Code §354.1452
  • 1 Texas Administrative Code §370.601

Background

S.B. 8, 83rd Legislature, Regular Session, 2013, prohibits certain provider marketing activities under Medicaid fee-for-service, Medicaid Managed Care, CHIP, Children’s Medicaid Dental, and CHIP Dental.   These guidelines are intended to assist providers in assessing their compliance with the rules and provide information on the option of submitting provider marketing to HHSC for review and approval. These guidelines go into effect July 6, 2014.

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