Texas Statutes
Subtitle F - Physicians and Health Care Providers
Chapter 1467 - Out-of-Network Claim Dispute Resolution

Subchapter A. General Provisions

Section 1467.001. Definitions - Sec. 1467.001. DEFINITIONS. In this chapter: (1) "Administrator" means: (A)...

Section 1467.002. Applicability of Chapter - Sec. 1467.002. APPLICABILITY OF CHAPTER. This chapter applies to: (1)...

Section 1467.003. Rules - Sec. 1467.003. RULES. (a) The commissioner, the Texas Medical Board,...

Section 1467.004. Remedies Not Exclusive - Sec. 1467.004. REMEDIES NOT EXCLUSIVE. The remedies provided by this...

Section 1467.005. Reform - Sec. 1467.005. REFORM. This chapter may not be construed to...

Section 1467.006. Benchmarking Database - Sec. 1467.006. BENCHMARKING DATABASE. (a) In this section, "geozip area"...

Subchapter B. Mandatory Mediation for Out-of-Network Facilities

Section 1467.050. Applicability of Subchapter - Sec. 1467.050. APPLICABILITY OF SUBCHAPTER. (a) This subchapter applies only...

Section 1467.0505. Establishment and Administration of Mediation Program - Sec. 1467.0505. ESTABLISHMENT AND ADMINISTRATION OF MEDIATION PROGRAM. (a) The...

Section 1467.051. Availability of Mandatory Mediation - Sec. 1467.051. AVAILABILITY OF MANDATORY MEDIATION. (a) An out-of-network provider...

Section 1467.052. Mediator Qualifications - Sec. 1467.052. MEDIATOR QUALIFICATIONS. (a) Except as provided by Subsection...

Section 1467.053. Appointment of Mediator; Fees - Sec. 1467.053. APPOINTMENT OF MEDIATOR; FEES. (a) A mediation shall...

Section 1467.054. Request and Preliminary Procedures for Mandatory Mediation - Sec. 1467.054. REQUEST AND PRELIMINARY PROCEDURES FOR MANDATORY MEDIATION. (a)...

Section 1467.055. Conduct of Mediation; Confidentiality - Sec. 1467.055. CONDUCT OF MEDIATION; CONFIDENTIALITY. (a) A mediator may...

Section 1467.056. Matters Considered in Mediation; Agreed Resolution - Sec. 1467.056. MATTERS CONSIDERED IN MEDIATION; AGREED RESOLUTION. (a) In...

Section 1467.0575. Right to File Action - Sec. 1467.0575. RIGHT TO FILE ACTION. Not later than the...

Section 1467.060. Report of Mediator - Sec. 1467.060. REPORT OF MEDIATOR. Not later than the 45th...

Subchapter B. -1. Mandatory Binding Arbitration for Other Providers

Section 1467.081. Applicability of Subchapter - Sec. 1467.081. APPLICABILITY OF SUBCHAPTER. This subchapter applies only with...

Section 1467.082. Establishment and Administration of Arbitration Program - Sec. 1467.082. ESTABLISHMENT AND ADMINISTRATION OF ARBITRATION PROGRAM. (a) The...

Section 1467.083. Issue to Be Addressed; Basis for Determination - Sec. 1467.083. ISSUE TO BE ADDRESSED; BASIS FOR DETERMINATION. (a)...

Section 1467.084. Availability of Mandatory Arbitration - Sec. 1467.084. AVAILABILITY OF MANDATORY ARBITRATION. (a) Not later than...

Section 1467.085. Effect of Arbitration and Applicability of Other Law - Sec. 1467.085. EFFECT OF ARBITRATION AND APPLICABILITY OF OTHER LAW....

Section 1467.086. Selection and Approval of Arbitrator - Sec. 1467.086. SELECTION AND APPROVAL OF ARBITRATOR. (a) If the...

Section 1467.087. Procedures - Sec. 1467.087. PROCEDURES. (a) The arbitrator shall set a date...

Section 1467.088. Decision - Sec. 1467.088. DECISION. (a) Not later than the 51st day...

Section 1467.089. Effect of Decision - Sec. 1467.089. EFFECT OF DECISION. (a) An arbitrator's decision under...

Subchapter C. Bad Faith Participation

Section 1467.101. Bad Faith - Sec. 1467.101. BAD FAITH. (a) The following conduct constitutes bad...

Section 1467.102. Penalties - Sec. 1467.102. PENALTIES. (a) Bad faith participation or otherwise failing...

Subchapter D. Complaints; Consumer Protection

Section 1467.151. Consumer Protection; Rules - Sec. 1467.151. CONSUMER PROTECTION; RULES. (a) The commissioner and the...