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Texas Insurance Code - INS § 845.053. Requirements Applicable to Certain Plans

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

(a) Except as provided by Subsection (b), if the system seeks to sponsor, arrange for the provision of, or provide health care services to enrollees in exchange for a predetermined payment per enrollee on a prepaid basis, the system must comply with:

(1) all requirements under this code imposed on health plans, including health maintenance organizations; and

(2) any additional requirements the commissioner determines are necessary to ensure enrollee access to health care providers and health care services.

(b) The system is not required to comply with requirements described by Subdivision (a)(1) that relate to mileage, distance, network adequacy, and scope of coverage that the commissioner determines are not applicable to the system.

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Cite this article: FindLaw.com - Texas Insurance Code - INS § 845.053. Requirements Applicable to Certain Plans - last updated January 01, 2024 | https://codes.findlaw.com/tx/insurance-code/ins-sect-845-053/

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