Sec. 1301.062. PREFERRED PROVIDER CONTRACTS BETWEEN INSURERS AND PODIATRISTS. A preferred provider contract between an insurer and a podiatrist licensed by the Texas Department of Licensing and Regulation must provide that:
(1) the podiatrist may request a copy of the coding guidelines and payment schedules applicable to the compensation that the podiatrist will receive under the contract for services;
(2) the insurer shall provide a copy of the coding guidelines and payment schedules not later than the 30th day after the date of the podiatrist's request;
(3) the insurer may not unilaterally make material retroactive revisions to the coding guidelines and payment schedules; and
(4) the podiatrist may, practicing within the scope of the law regulating podiatry, furnish x-rays and nonprefabricated orthotics covered by the health insurance policy.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.
Amended by:
Acts 2019, 86th Leg., R.S., Ch. 467 (H.B. 4170), Sec. 19.014, eff. September 1, 2019.
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