Tex. Insurance Code § 4201.652: APPLICABILITY OF SUBCHAPTER.
Where this section sits in the code
- INSURANCE CODE
- TITLE 14. UTILIZATION REVIEW AND INDEPENDENT REVIEW
- CHAPTER 4201. UTILIZATION REVIEW AGENTS
- SUBCHAPTER N. EXEMPTION FROM PREAUTHORIZATION REQUIREMENTS FOR PHYSICIANS AND PROVIDERS PROVIDING CERTAIN HEALTH CARE SERVICES
This subchapter applies only to:
(1) a health benefit plan offered by a health maintenance organization operating under Chapter 843, except that this subchapter does not apply to:
(A) the child health plan program under Chapter 62, Health and Safety Code, or the health benefits plan for children under Chapter 63, Health and Safety Code; or
(B) the state Medicaid program, including the Medicaid managed care program operated under Chapter 540 or 540A, Government Code, as applicable;
(2) a preferred provider benefit plan or exclusive provider benefit plan offered by an insurer under Chapter 1301; and
(3) a person who contracts with a health maintenance organization or insurer to issue preauthorization determinations or perform the functions described in this subchapter for a health benefit plan to which this subchapter applies.
Added by Acts 2021, 87th Leg., R.S., Ch. 1018 (H.B. 3459), Sec. 5, eff. September 1, 2021.
Amended by:
Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 2.140, eff. April 1, 2025.
Collected 2026-08-27T01:47:21Z. Source file · JSON