Sec. 1217.003.  EXCEPTION.  This chapter does not apply to:
(1)  a health benefit plan that provides coverage:
(A)  only for a specified disease or for another single benefit;
(B)  only for accidental death or dismemberment;
(C)  only for wages or payments in lieu of wages for a period during which an employee is absent from work because of sickness or injury;
(D)  as a supplement to a liability insurance policy;
(E)  for credit insurance;
(F)  only for dental or vision care;
(G)  only for hospital expenses; or
(H)  only for indemnity for hospital confinement;
(2)  a Medicare supplemental policy as defined by Section 1882, Social Security Act (42 U.S.C. Section 1395ss);
(3)  medical payment insurance coverage provided under a motor vehicle insurance policy;
(4)  a long-term care insurance policy, including a nursing home fixed indemnity policy, unless the commissioner determines that the policy provides benefit coverage so comprehensive that the policy is a health benefit plan as described by Section 1217.002; or
(5)  a workers' compensation insurance policy.
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