The Law Office of Susan M. Erickson, PLLC
Based in Austin, Texas, The Law Office of Susan M. Erickson provides high-quality legal services in the areas of managed care, Medicaid managed care, Medicare Advantage plans, health insurance regulatory and general health law.
THE FIRM
The Firm
Susan M. Erickson opened the firm in 2015 in Austin, Texas, with a focus on managed care and health insurance regulatory matters, Medicaid managed care, Medicare Advantage plans, and general health care law. Ms. Erickson has more than 30 years of experience in these areas, gained during many years of practice with the insurance regulatory group of a major international law firm and as in-house general counsel to Texas' largest Medicaid managed care organization. She also spent time as in-house counsel to one of the leading digital health, AI-enabled value-based care companies, where she was lead counsel in drafting and negotiating innovative value-based care contracts with a range of commercial and government-sponsored payors.
CONTACT US
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Tel: 512-762-5852
Fax: 512-_________
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​​106 Dove Tail Ln.
Georgetown, TX 78628
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Practice Areas
Health Insurance and Health Plan Regulatory and Transactional Matters
Medicaid Managed Care Law
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Medicare Advantage Plans
General Health Care Law
News
July 2026
HHSC-OIG Releases Third Quarterly Report on Medicaid Fraud, Waste, and Abuse Activities
The Texas HHSC-Office of the Inspector General has released its Third Quarterly Report of State Fiscal Year 2026. The report highlights Medicaid fraud, waste and abuse recoveries and savings of $148 Million for the quarter. It also describes OIG investigations into non-emergency transportation services and into numerous home health agencies.
Spring/Summer 2026
Texas Department of Insurance Proposed Rules.
In the past six months, the Texas Department of Insurance (TDI) has issued numerous proposed rules impacting HMOs and health insurance carriers doing business in the state. The rules are intended to implement legislation enacted during Texas's 2025 legislative session. They address PPO/EPO network adequacy requirements, health plan publication of price transparency files, coordination of benefits, prior authorization gold-carding, and vision plans' provider contracts, among other topics. You may visit TDI's Proposed and Adopted Rules Page to find the text and information about public hearings on these proposals.
January 2024
CMS Issues Interoperability and Prior Authorization Final Rule.
On January 17, 2024, CMS issued a Final Rule that is intended to improve prior authorization processes and patient, provider, and payer communications through access to interoperable patient data. The Final Rule requires payers to implement several application programming interfaces by 2027. The Final Rule also shortens the timeframes within which payers must respond to standard and expedited prior authorization requests. It applies to Medicare Advantage plans, Medicaid and CHIP managed care plans, and QHPs offered on federally-facilitated exchanges.
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Upcoming Reporting Deadlines:
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TDI Commercial HMO Network Adequacy Report -- due August 15
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Gag Clause Prohibition Compliance Attestation (CMS) -- due December 31
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