Insurance Code § 1271.005

This section says several other insurance laws apply to health maintenance organizations, with one narrow exception, and requires an HMO to follow prompt-payment rules for enrollee payments.

Jurisdiction: United States — Texas
Instrument: Code
Version: Undated source snapshot
Language: en
Official source: View official record ↗

applicability of other law health maintenance organizations

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1271.005
Insurance Code § 1271.005
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This section says several other insurance laws apply to health maintenance organizations, with one narrow exception, and requires an HMO to follow prompt-payment rules for enrollee payments.

Sec. 1271.005. APPLICABILITY OF OTHER LAW. (a) Chapters 1368 and 1652 apply to a health maintenance organization other than a health maintenance organization that offers only a single health care service plan. (b) Subchapter B, Chapter 1355, applies to a health maintenance organization providing benefits for mental health treatment in a residential treatment center for children and adolescents or crisis stabilization unit to the extent that: (1) Subchapter B, Chapter 1355, does not conflict with this chapter, Chapter 843, Subchapter A, Chapter 1452, or Subchapter B, Chapter 1507; and (2) the residential treatment center for children and adolescents or crisis stabilization unit is located within the service area of the health maintenance organization and is subject to inspection and review as required by this chapter, Chapter 843, Subchapter A, Chapter 1452, or Subchapter B, Chapter 1507, or rules adopted under this chapter, Chapter 843, Subchapter A, Chapter 1452, or Subchapter B, Chapter 1507. (c) A health maintenance organization shall comply with Subchapter B, Chapter 542, with respect to prompt payment to an enrollee. (d) Notwithstanding any other law, Subchapter C, Chapter 1355, applies to a group contract issued by a health maintenance organization. (e) Notwithstanding any other law, Section 1201.062 applies to an evidence of coverage issued by a health maintenance organization. Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005. Amended by: Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.074(b), eff. September 1, 2005.

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Insurance Code § 1271.005

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