Texas Statutes
Subchapter A. General Provisions
Section 1301.0058. Protected Communications by Preferred Providers

Sec. 1301.0058. PROTECTED COMMUNICATIONS BY PREFERRED PROVIDERS. (a) An insurer may not in any manner prohibit, attempt to prohibit, penalize, terminate, or otherwise restrict a preferred provider from communicating with an insured about the availability of out-of-network providers for the provision of the insured's medical or health care services.
(b) An insurer may not terminate the contract of or otherwise penalize a preferred provider solely because the provider's patients use out-of-network providers for medical or health care services.
(c) An insurer's contract with a preferred provider may require that, except in a case of a medical emergency as determined by the preferred provider, before the provider may make an out-of-network referral for an insured, the preferred provider inform the insured:
(1) that:
(A) the insured may choose a preferred provider or an out-of-network provider; and
(B) if the insured chooses the out-of-network provider the insured may incur higher out-of-pocket expenses; and
(2) whether the preferred provider has a financial interest in the out-of-network provider.
Added by Acts 2015, 84th Leg., R.S., Ch. 275 (H.B. 574), Sec. 5, eff. September 1, 2015.

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