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Texas Insurance Code - INS § 1272.208. Authority of Commissioner to Issue Order

Current as of January 01, 2024 | Updated by Findlaw Staff

(a) Regardless of whether a delegated entity complies with a request for corrective action under Section 1272.207, the commissioner may order a health maintenance organization with which the entity has entered into a delegation agreement to take any action the commissioner determines is necessary to ensure that the health maintenance organization is complying with this chapter, Chapter 843, 1271, or 1367, Subchapter A, Chapter 1452, or Subchapter B, Chapter 1507.  1

(b) Actions the commissioner may order a health maintenance organization to take under this section include:

(1) reassuming the functions delegated to the delegated entity, including claims payments for services previously provided to enrollees;

(2) temporarily or permanently ceasing assignment of new enrollees to the entity;

(3) temporarily or permanently transferring enrollees to alternative delivery systems to receive services; or

(4) terminating the delegation agreement with the entity.

1 V.T.C.A., Insurance Code §§ 1452.001 et seq. or 1507.051 et seq.
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Cite this article: FindLaw.com - Texas Insurance Code - INS § 1272.208. Authority of Commissioner to Issue Order - last updated January 01, 2024 | https://codes.findlaw.com/tx/insurance-code/ins-sect-1272-208/

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