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Texas · Through 89th 2nd Called Legislative Session, 2025

Tex. Insurance Code § 1452.106: EFFECT OF FAILURE TO MEET CREDENTIALING REQUIREMENTS.

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Where this section sits in the code
  1. INSURANCE CODE
  2. TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES
  3. SUBTITLE F. PHYSICIANS AND HEALTH CARE PROVIDERS
  4. CHAPTER 1452. PHYSICIAN AND PROVIDER CREDENTIALS
  5. SUBCHAPTER C. EXPEDITED CREDENTIALING PROCESS FOR CERTAIN PHYSICIANS

If, on completion of the credentialing process, the managed care plan issuer determines that the applicant physician does not meet the issuer's credentialing requirements:

(1) the managed care plan issuer may recover from the applicant physician or the physician's medical group an amount equal to the difference between payments for in-network benefits and out-of-network benefits; and

(2) the applicant physician or the physician's medical group may retain any copayments collected or in the process of being collected as of the date of the issuer's determination.

Added by Acts 2007, 80th Leg., R.S., Ch. 1203 (H.B. 1594), Sec. 1, eff. September 1, 2007.

Collected 2026-08-27T01:47:21Z. Source file · JSON

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