GroundRules
Tex. Insurance Code § 1301.152: CONTINUING CARE IN GENERAL.
Where this section sits in the code
- INSURANCE CODE
- TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES
- SUBTITLE D. PROVIDER PLANS
- CHAPTER 1301. PREFERRED PROVIDER BENEFIT PLANS
- SUBCHAPTER D. RELATIONS BETWEEN INSUREDS AND PREFERRED PROVIDERS
(a) An insurer shall establish reasonable procedures for ensuring a transition of insureds to physicians or health care providers and for continuity of treatment.
(b) An insurer shall:
(1) provide, subject to Section 1301.160, reasonable advance notice to an insured of the impending termination of the participation in the plan of a physician or health care provider who is currently treating the insured; and
(2) in the event of termination of a preferred provider's participation in the plan, make available to the insured a current listing of preferred providers.
(c) A contract between an insurer and a physician or health care provider must include a procedure for resolving disputes regarding the necessity for continued treatment by the physician or provider.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.
Collected 2026-08-27T01:47:21Z. Source file · JSON