(a) Prohibited marketing activities. A provider participating
in the Medicaid or child health plan program, including a provider
participating in the network of a managed care organization that contracts
with the Health and Human Services Commission to provide services
under the Medicaid or child health plan program, may not engage in
any marketing activity, including any dissemination of material or
other attempt to communicate, that:
  (1) Involves unsolicited personal contact, including
by door-to-door solicitation, solicitation at a child care facility
or other type of facility, direct mail, or telephone, with a Medicaid
client or a parent whose child is enrolled in the Medicaid or child
health plan program;
  (2) Is directed at the client or parent solely because
the client or the parent's child is receiving benefits under the Medicaid
or child health plan program; and
  (3) Is intended to influence the client's or parent's
choice of provider.
(b) Permissible marketing activities by providers participating
in Medicaid or child health plan programs. Nothing in this rule prohibits
a provider participating in the Medicaid or child health plan program
from:
  (1) Engaging in a marketing activity, including any
dissemination of material or other attempt to communicate, that is
intended to influence the choice of provider by a Medicaid client
or a parent whose child is enrolled in the Medicaid program, if the
marketing activity:
    (A) Is conducted at a community-sponsored educational
event, health fair, outreach activity, or other similar community
or nonprofit event in which the provider participates and does not
involve unsolicited personal contact or promotion of the provider's
practice that is not used as part of health education; or
    (B) Involves only the general dissemination of information,
including by television, radio, newspaper, or billboard advertisement,
and does not involve unsolicited personal contact;
  (2) As permitted under the provider's contract, engaging
in the dissemination of material or another attempt to communicate
with a Medicaid client or a parent whose child is enrolled in the
Medicaid program or child health plan program, including communication
in person or by direct mail or telephone, for the purpose of:
    (A) Providing an appointment reminder;
    (B) Distributing promotional health materials;
    (C) Providing information about the types of services
offered by the provider; or
    (D) Coordinating patient care; or
  (3) Engaging in a marketing activity that has been
submitted for review and obtained a notice of prior authorization
from the Health and Human Services Commission under subsection (c)
of this section.
(c) Review and prior authorization. At the provider's
option, a provider participating in the Medicaid program may submit
proposed marketing materials to the Health and Human Services Commission
for review and prior authorization to ensure that the materials are
in compliance with this rule. The Commission may grant or deny a provider's
request for prior authorization.


Source Note: The provisions of this §354.1452 adopted to be effective July 6, 2014, 39 TexReg 4952