Sec. 1301.0045. CONSTRUCTION OF CHAPTER. (a) Except as provided by Section 1301.0046, this chapter may not be construed to limit the level of reimbursement or the level of coverage, including deductibles, copayments, coinsurance, or other cost-sharing provisions, that are applicable to preferred providers or, for plans other than exclusive provider benefit plans, nonpreferred providers.
(b) Except as provided by Sections 1301.0052, 1301.0053, 1301.155, 1301.164, and 1301.165, this chapter may not be construed to require an exclusive provider benefit plan to compensate a nonpreferred provider for services provided to an insured.
Added by Acts 2005, 79th Leg., Ch. 1221 (H.B. 1030), Sec. 1, eff. September 1, 2005.
Amended by:
Acts 2011, 82nd Leg., R.S., Ch. 288 (H.B. 1772), Sec. 6, eff. September 1, 2011.
Acts 2019, 86th Leg., R.S., Ch. 1342 (S.B. 1264), Sec. 1.05, eff. September 1, 2019.
Structure Texas Statutes
Title 8 - Health Insurance and Other Health Coverages
Chapter 1301 - Preferred Provider Benefit Plans
Subchapter A. General Provisions
Section 1301.002. Nonapplicability to Dental Care Benefits
Section 1301.003. Preferred Provider Benefit Plans and Exclusive Provider Benefit Plans Permitted
Section 1301.0041. Applicability
Section 1301.0042. Applicability of Insurance Law
Section 1301.0045. Construction of Chapter
Section 1301.0046. Coinsurance Requirements for Services of Nonpreferred Providers
Section 1301.005. Availability of Preferred Providers
Section 1301.0051. Exclusive Provider Benefit Plans: Quality Improvement and Utilization Management
Section 1301.0052. Exclusive Provider Benefit Plans: Referrals for Medically Necessary Services
Section 1301.0053. Exclusive Provider Benefit Plans: Emergency Care
Section 1301.0055. Network Adequacy Standards
Section 1301.0056. Examinations and Fees
Section 1301.0057. Access to Out-of-Network Providers
Section 1301.0058. Protected Communications by Preferred Providers
Section 1301.006. Availability of and Accessibility to Health Care Services
Section 1301.0061. Terms of Enrollee Eligibility
Section 1301.008. Conflict With Other Law