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

Tex. Insurance Code § 1452.206: 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 E. EXPEDITED CREDENTIALING PROCESS FOR CERTAIN THERAPEUTIC OPTOMETRISTS

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

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

(2) the applicant therapeutic optometrist or the therapeutic optometrist's professional practice may retain any copayments collected or in the process of being collected as of the date of the issuer's determination.

Added by Acts 2013, 83rd Leg., R.S., Ch. 79 (S.B. 365), Sec. 1, eff. September 1, 2013.

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

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