{"data":{"id":"us-tx/tex.-insurance-code-1217.002","jurisdiction":"us-tx","citation":"Tex. Insurance Code § 1217.002","heading":"APPLICABILITY OF CHAPTER.","body":"(a) This chapter applies only to a health benefit plan that provides benefits for medical or surgical expenses incurred as a result of a health condition, accident, or sickness, including an individual, group, blanket, or franchise insurance policy or insurance agreement, a group hospital service contract, or a small or large employer group contract or similar coverage document that is offered by:\n(1) an insurance company;\n(2) a group hospital service corporation operating under Chapter 842;\n(3) a fraternal benefit society operating under Chapter 885;\n(4) a stipulated premium company operating under Chapter 884;\n(5) a reciprocal exchange operating under Chapter 942;\n(6) a health maintenance organization operating under Chapter 843;\n(7) a multiple employer welfare arrangement that holds a certificate of authority under Chapter 846; or\n(8) an approved nonprofit health corporation that holds a certificate of authority under Chapter 844.\n(b) This chapter applies to group health coverage made available by a school district in accordance with Section 22.004, Education Code.\n(c) Notwithstanding any provision in Chapter 1551, 1575, 1579, or 1601 or any other law, this chapter applies to:\n(1) a basic coverage plan under Chapter 1551;\n(2) a basic plan under Chapter 1575;\n(3) a primary care coverage plan under Chapter 1579; and\n(4) basic coverage under Chapter 1601.\n(d) Notwithstanding any other law, this chapter applies to coverage under:\n(1) 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; and\n(2) a Medicaid managed care program operated under Chapter 540 or 540A, Government Code, as applicable, or a Medicaid program operated under Chapter 32, Human Resources Code.\nAdded by Acts 2013, 83rd Leg., R.S., Ch. 1198 (S.B. 1216), Sec. 1, eff. September 1, 2013.\nAmended by:\nActs 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 2.120, eff. April 1, 2025.","path":["INSURANCE CODE","TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES","SUBTITLE A. HEALTH COVERAGE IN GENERAL","CHAPTER 1217. STANDARD REQUEST FORM FOR PRIOR AUTHORIZATION OF HEALTH CARE SERVICES"],"source_url":"https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1217.htm#1217.002","current_through":"89th 2nd Called Legislative Session, 2025","vintage":"","retrieved_at":"2026-08-27T01:47:21Z","sha256":"76cd0b6ca5a4298d50cabdeff15e44cee9076b6ea00870657098163140e4620a","source_id":"us-tx","stale":false,"prev":"us-tx/tex.-insurance-code-1217.001","next":"us-tx/tex.-insurance-code-1217.003"},"notice":"GroundRules: Original legal text. Not legal advice."}