Sec. 1217.001. DEFINITIONS. In this chapter:
(1) "Health benefit plan issuer" means an entity authorized under this code or another insurance law of this state that delivers or issues for delivery a health benefit plan or other coverage that is covered under this chapter as described by Section 1217.002. The term includes:
(A) an insurance company;
(B) a group hospital service corporation operating under Chapter 842;
(C) a fraternal benefit society operating under Chapter 885;
(D) a stipulated premium company operating under Chapter 884;
(E) a reciprocal exchange operating under Chapter 942;
(F) a health maintenance organization operating under Chapter 843;
(G) a multiple employer welfare arrangement that holds a certificate of authority under Chapter 846; or
(H) an approved nonprofit health corporation that holds a certificate of authority under Chapter 844.
(2) "Health care services" includes medical or health care treatments, consultations, procedures, drugs, supplies, imaging and diagnostic services, inpatient and outpatient care, medical devices, and durable medical equipment. The term does not include prescription drugs as defined by Section 551.003, Occupations Code.
Added by Acts 2013, 83rd Leg., R.S., Ch. 1198 (S.B. 1216), Sec. 1, eff. September 1, 2013.
Structure Texas Statutes
Title 8 - Health Insurance and Other Health Coverages
Subtitle A - Health Coverage in General
Chapter 1217 - Standard Request Form for Prior Authorization of Health Care Services
Section 1217.002. Applicability of Chapter
Section 1217.004. Standard Form
Section 1217.005. Advisory Committee on Uniform Prior Authorization Forms