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

Tex. Insurance Code § 1452.107: ENROLLEE HELD HARMLESS.

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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

An enrollee in the managed care plan is not responsible and shall be held harmless for the difference between in-network copayments paid by the enrollee to a physician who is determined to be ineligible under Section 1452.106 and the managed care plan's charges for out-of-network services. The physician and the physician's medical group may not charge the enrollee for any portion of the physician's fee that is not paid or reimbursed by the enrollee's managed care plan.

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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