Skip to main content
Find a Lawyer

Texas Insurance Code - INS § 1467.151. Consumer Protection;  Rules

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

(a) The commissioner and the Texas Medical Board or other regulatory agency, as appropriate, shall adopt rules regulating the investigation and review of a complaint filed that relates to the settlement of an out-of-network health benefit claim that is subject to this chapter.  The rules adopted under this section must:

(1) distinguish among complaints for out-of-network coverage or payment and give priority to investigating allegations of delayed health care or medical care;

(2) develop a form for filing a complaint;  and

(3) ensure that a complaint is not dismissed without appropriate consideration.

(b) The department and the Texas Medical Board or other appropriate regulatory agency shall maintain information on each complaint filed that concerns a claim, arbitration, or mediation subject to this chapter, including:

(1) the type of services or supplies that gave rise to the dispute;

(2) the type and specialty, if any, of the out-of-network provider who provided the out-of-network service or supply;

(3) the county and metropolitan area in which the health care or medical service or supply was provided;

(4) whether the health care or medical service or supply was for emergency care;  and

(5) any other information about:

(A) the health benefit plan issuer or administrator that the commissioner by rule requires;  or

(B) the out-of-network provider that the Texas Medical Board or other appropriate regulatory agency by rule requires.

(c) The information collected and maintained under Subsection (b) is public information as defined by Section 552.002, Government Code, and may not include personally identifiable information or health care or medical information.

(d) Repealed by Acts 2019, 86th Leg., ch. 1342 (S.B. 1264), § 3.03(11).

Previous Part of Code Next Part of Code
Back to Chapter List

Cite this article: FindLaw.com - Texas Insurance Code - INS § 1467.151. Consumer Protection;  Rules - last updated January 01, 2024 | https://codes.findlaw.com/tx/insurance-code/ins-sect-1467-151/

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.

Was this helpful?

Welcome to FindLaw's Cases & Codes

A free source of state and federal court opinions, state laws, and the United States Code. For more information about the legal concepts addressed by these cases and statutes, visit FindLaw’s Learn About the Law.

Go to Learn About the Law

Latest Blog Posts

For Legal Professionals

Learn About The Law

Get help with your legal needs

FindLaw’s Learn About the Law features thousands of informational articles to help you understand your options. And if you’re ready to hire an attorney, find one in your area who can help.

Go to Learn About the Law

Need to Find an Attorney?

Search our directory by legal issue

Enter information in one or both fields (Required)

Copied to clipboard