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

Tex. Insurance Code § 752.0003: ENFORCEMENT BY REGULATORY AGENCY.

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Where this section sits in the code
  1. INSURANCE CODE
  2. TITLE 5. PROTECTION OF CONSUMER INTERESTS
  3. SUBTITLE G. REGULATION OF INSURER MARKET CONDUCT
  4. CHAPTER 752. ENFORCEMENT OF BALANCE BILLING PROHIBITIONS

(a) An appropriate regulatory agency that licenses, certifies, or otherwise authorizes a physician, health care practitioner, health care facility, or other health care provider to practice or operate in this state may take disciplinary action against the physician, practitioner, facility, or provider if the physician, practitioner, facility, or provider violates a law that prohibits the physician, practitioner, facility, or provider from billing an insured, participant, or enrollee in an amount greater than an applicable copayment, coinsurance, and deductible under the insured's, participant's, or enrollee's managed care plan or that imposes a requirement related to that prohibition.

(b) The department may take disciplinary action against a health benefit plan issuer or administrator if the issuer or administrator violates a law requiring the issuer or administrator to provide notice of a balance billing prohibition or make a related disclosure.

(c) A regulatory agency described by Subsection (a) or the commissioner may adopt rules as necessary to implement this section. Section 2001.0045, Government Code, does not apply to rules adopted under this subsection.

Added by Acts 2019, 86th Leg., R.S., Ch. 1342 (S.B. 1264), Sec. 1.01, eff. September 1, 2019.

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

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