Tex. Insurance Code § 843.351
SERVICES PROVIDED BY CERTAIN PHYSICIANS AND PROVIDERS
Texas · Texas Insurance Code · Status: effective
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- Citation
- Tex. Insurance Code § 843.351, SERVICES PROVIDED BY CERTAIN PHYSICIANS AND PROVIDERS, Texas, version 1 as recorded 2026-07-09, yourstate.us, https://yourstate.us/provision/679538
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Full text
The provisions of this subchapter relating to prompt payment by a health maintenance organization of a physician or provider and to verification of health care services apply to a physician or provider who:
(1) is not included in the health maintenance organization delivery network; and
(2) provides to an enrollee:
(A) care related to an emergency or its attendant episode of care as required by state or federal law; or
(B) specialty or other health care services at the request of the health maintenance organization or a physician or provider who is included in the health maintenance organization delivery network because the services are not reasonably available within the network.