{"data":{"id":"us-tx/tex.-insurance-code-4201.652","jurisdiction":"us-tx","citation":"Tex. Insurance Code § 4201.652","heading":"APPLICABILITY OF SUBCHAPTER.","body":"This subchapter applies only to:\n(1) a health benefit plan offered by a health maintenance organization operating under Chapter 843, except that this subchapter does not apply to:\n(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\n(B) the state Medicaid program, including the Medicaid managed care program operated under Chapter 540 or 540A, Government Code, as applicable;\n(2) a preferred provider benefit plan or exclusive provider benefit plan offered by an insurer under Chapter 1301; and\n(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.\nAdded by Acts 2021, 87th Leg., R.S., Ch. 1018 (H.B. 3459), Sec. 5, eff. September 1, 2021.\nAmended by:\nActs 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 2.140, eff. April 1, 2025.","path":["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"],"source_url":"https://statutes.capitol.texas.gov/Docs/IN/htm/IN.4201.htm#4201.652","current_through":"89th 2nd Called Legislative Session, 2025","vintage":"","retrieved_at":"2026-08-27T01:47:21Z","sha256":"0ad5ef1b2cd8ea0636039b9c0997f789d12456d23f0c4fd69669269c56559101","source_id":"us-tx","stale":false,"prev":"us-tx/tex.-insurance-code-4201.651","next":"us-tx/tex.-insurance-code-4201.653"},"notice":"GroundRules: Original legal text. Not legal advice."}