Sec. 1301.006. AVAILABILITY OF AND ACCESSIBILITY TO HEALTH CARE SERVICES. (a) An insurer that markets a preferred provider benefit plan shall contract with physicians and health care providers to ensure that all medical and health care services and items contained in the package of benefits for which coverage is provided, including treatment of illnesses and injuries, will be provided under the health insurance policy in a manner ensuring availability of and accessibility to adequate personnel, specialty care, and facilities.
(b) A contract between an insurer that markets a plan regulated under this chapter and an institutional provider may not, as a condition of staff membership or privileges, require a physician or other practitioner to enter into a preferred provider contract.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.
Amended by:
Acts 2011, 82nd Leg., 1st C.S., Ch. 7 (S.B. 7), Sec. 10.01, eff. September 28, 2011.
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