Tex. Insurance Code § 843.316
ALTERNATIVE CAPITATION SYSTEM
Texas · Texas Insurance Code · Status: effective
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- Citation
- Tex. Insurance Code § 843.316, ALTERNATIVE CAPITATION SYSTEM, Texas, version 1 as recorded 2026-07-09, yourstate.us, https://yourstate.us/provision/679509
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Full text
As an alternative to the procedures prescribed by Section 843.315, a health maintenance organization may request approval from the department of a capitation payment system that ensures:
(1) immediate availability and accessibility of a primary care physician or primary care provider; and
(2) payment to a primary care physician or primary care provider of a capitated amount certified by a qualified actuary to be actuarially sufficient to compensate the primary care physician or primary care provider for the risk assumed.