Sec. 1301.052. DESIGNATION OF ADVANCED PRACTICE NURSE OR PHYSICIAN ASSISTANT AS PREFERRED PROVIDER. An insurer offering a preferred provider benefit plan may not refuse a request made by a physician participating as a preferred provider under the plan and an advanced practice nurse or physician assistant to have the advanced practice nurse or physician assistant included as a preferred provider under the plan if:
(1) the advanced practice nurse or physician assistant is authorized by the physician to provide care under Subchapter B, Chapter 157, Occupations Code; and
(2) the advanced practice nurse or physician assistant meets the quality of care standards previously established by the insurer for participation in the plan by advanced practice nurses and physician assistants.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.
Structure Texas Statutes
Title 8 - Health Insurance and Other Health Coverages
Chapter 1301 - Preferred Provider Benefit Plans
Subchapter B. Relations With Physicians or Health Care Providers
Section 1301.051. Designation as Preferred Provider
Section 1301.0515. Acupuncturist Services
Section 1301.0516. Chiropractic Services
Section 1301.0521. Designation of Certain Podiatrists as Preferred Providers
Section 1301.053. Appeal Relating to Designation as Preferred Provider
Section 1301.054. Notice to Practitioners of Preferred Provider Benefit Plan
Section 1301.055. Complaint Resolution
Section 1301.056. Restrictions on Payment and Reimbursement
Section 1301.057. Termination of Participation; Expedited Review Process
Section 1301.058. Economic Profiling
Section 1301.059. Quality Assessment
Section 1301.060. Compensation on Discounted Fee Basis
Section 1301.061. Preferred Provider Networks
Section 1301.062. Preferred Provider Contracts Between Insurers and Podiatrists
Section 1301.0625. Health Care Collaboratives
Section 1301.063. Contract Provisions Relating to Use of Hospitalist
Section 1301.064. Contract Provisions Relating to Payment of Claims
Section 1301.0641. Contract Provisions Prohibiting Rejection of Batched Claims
Section 1301.065. Shifting of Insurer's Tort Liability Prohibited
Section 1301.066. Retaliation Against Preferred Provider Prohibited
Section 1301.068. Inducement to Limit Medically Necessary Services Prohibited
Section 1301.069. Services Provided by Certain Physicians and Health Care Providers