Sec. 1301.1353. REMEDY FOR NONCOMPLIANCE. (a) In addition to any other penalty or remedy provided by law, an insurer that uses a preauthorization process for medical care or health care services that violates this subchapter with respect to a required publication, notice, or response regarding its preauthorization requirements, including by failing to comply with any applicable deadline for the publication, notice, or response, must provide an expedited appeal under Section 4201.357 for any medical care or health care service affected by the violation.
(b) The provisions of this section may not be waived, voided, or nullified by contract.
Added by Acts 2019, 86th Leg., R.S., Ch. 1218 (S.B. 1742), Sec. 2.04, eff. September 1, 2019.
Structure Texas Statutes
Title 8 - Health Insurance and Other Health Coverages
Chapter 1301 - Preferred Provider Benefit Plans
Subchapter C. -1. Other Provisions Relating to Payment of Claims
Section 1301.131. Elements of Clean Claim
Section 1301.133. Verification
Section 1301.134. Coordination of Payment
Section 1301.135. Preauthorization of Medical and Health Care Services
Section 1301.1351. Posting of Preauthorization Requirements
Section 1301.1353. Remedy for Noncompliance
Section 1301.136. Availability of Coding Guidelines
Section 1301.137. Violation of Claims Payment Requirements; Penalty
Section 1301.138. Applicability to Entities Contracting With Insurer