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Current as of January 01, 2024 | Updated by Findlaw Staff
(a) In this section, “quality assessment” means a mechanism used by an insurer to evaluate, monitor, or improve the quality and effectiveness of the medical care delivered by physicians or health care providers to persons covered by a health insurance policy to ensure that the care delivered is consistent with the care delivered by an ordinary, reasonable, and prudent physician or health care provider under the same or similar circumstances.
(b) An insurer may not engage in quality assessment except through a panel of at least three physicians selected by the insurer from among a list of physicians contracting with the insurer. The physicians contracting with the insurer in the applicable service area shall provide the list of physicians to the insurer.
Cite this article: FindLaw.com - Texas Insurance Code - INS § 1301.059. Quality Assessment - last updated January 01, 2024 | https://codes.findlaw.com/tx/insurance-code/ins-sect-1301-059/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.
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