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Current as of January 01, 2024 | Updated by Findlaw Staff
In this subchapter:
(1) "Analysis program" means the Health Impact, Cost, and Coverage Analysis Program established under Section 38.452.
(2) "Center" means the Center for Health Care Data at The University of Texas Health Science Center at Houston.
(3) "Enrollee" means an individual who is enrolled in a health benefit plan, including a covered dependent.
(4) "Health benefit plan issuer" means an insurer, health maintenance organization, or other entity authorized to provide health benefits coverage under the laws of this state, including a Medicaid managed care organization. The term does not include an issuer of workers' compensation insurance.
(5) "Health benefits coverage" does not include workers' compensation.
(6) "Health care provider" means a physician, facility, or other person who is licensed, certified, registered, or otherwise authorized to provide a health care service in this state.
(7) "Health care service" means a service, procedure, drug, or device to diagnose, prevent, alleviate, cure, or heal a human disease, injury, or unhealthy or abnormal physical or mental condition, including a service, procedure, drug, or device related to pregnancy or delivery.
(8) "Mandate" means a provision contained in a legislative document that requires a health benefit plan issuer or administrator, with respect to health benefits coverage, to:
(A) provide coverage for a health care service;
(B) increase or decrease payments to health care providers for a health care service; or
(C) implement a new contractual or administrative requirement.
Cite this article: FindLaw.com - Texas Insurance Code - INS § 38.451. Definitions - last updated January 01, 2024 | https://codes.findlaw.com/tx/insurance-code/ins-sect-38-451/
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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