Sec. 1305.006. INSURANCE CARRIER LIABILITY FOR OUT-OF-NETWORK HEALTH CARE. An insurance carrier that establishes or contracts with a network is liable for the following out-of-network health care that is provided to an injured employee:
(1) emergency care;
(2) health care provided to an injured employee who does not live within the service area of any network established by the insurance carrier or with which the insurance carrier has a contract; and
(3) health care provided by an out-of-network provider pursuant to a referral from the injured employee's treating doctor that has been approved by the network pursuant to Section 1305.103.
Added by Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 4.02, eff. September 1, 2005.
Structure Texas Statutes
Title 8 - Health Insurance and Other Health Coverages
Chapter 1305 - Workers' Compensation Health Care Networks
Subchapter A. General Provisions
Section 1305.003. Limitations on Applicability
Section 1305.005. Participation in Network; Notice of Network Requirements
Section 1305.006. Insurance Carrier Liability for Out-of-Network Health Care
Section 1305.008. Administrator Certificate of Authority Required