Sec. 1467.089. EFFECT OF DECISION. (a) An arbitrator's decision under Section 1467.088 is binding.
(b) Not later than the 45th day after the date of an arbitrator's decision under Section 1467.088, a party not satisfied with the decision may file an action to determine the payment due to an out-of-network provider.
(c) In an action filed under Subsection (b), the court shall determine whether the arbitrator's decision is proper based on a substantial evidence standard of review.
(d) Not later than the 30th day after the date of an arbitrator's decision under Section 1467.088, a health benefit plan issuer or administrator shall pay to an out-of-network provider any additional amount necessary to satisfy the binding award.
Added by Acts 2019, 86th Leg., R.S., Ch. 1342 (S.B. 1264), Sec. 2.15, eff. September 1, 2019.
Structure Texas Statutes
Title 8 - Health Insurance and Other Health Coverages
Subtitle F - Physicians and Health Care Providers
Chapter 1467 - Out-of-Network Claim Dispute Resolution
Subchapter B. -1. Mandatory Binding Arbitration for Other Providers
Section 1467.081. Applicability of Subchapter
Section 1467.082. Establishment and Administration of Arbitration Program
Section 1467.083. Issue to Be Addressed; Basis for Determination
Section 1467.084. Availability of Mandatory Arbitration
Section 1467.085. Effect of Arbitration and Applicability of Other Law