Sec. 415.005. OVERCHARGING BY HEALTH CARE PROVIDERS PROHIBITED; ADMINISTRATIVE VIOLATION. (a) A health care provider commits a violation if the person charges an insurance carrier an amount greater than that normally charged for similar treatment to a payor outside the workers' compensation system, except for mandated or negotiated charges.
(b) A violation under this section is an administrative violation. A health care provider may be liable for an administrative penalty regardless of whether a criminal action is initiated under Section 413.043.
Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.
Amended by:
Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 3.269, eff. September 1, 2005.
Structure Texas Statutes
Title 5 - Workers' Compensation
Subtitle A - Texas Workers' Compensation Act
Chapter 415 - Administrative Violations
Section 415.001. Administrative Violation by Representative of Employee or Legal Beneficiary
Section 415.002. Administrative Violation by Insurance Carrier
Section 415.003. Administrative Violation by Health Care Provider
Section 415.0035. Additional Violations by Insurance Carrier or Health Care Provider
Section 415.0036. Administrative Violation by Person Performing Certain Claim Services
Section 415.005. Overcharging by Health Care Providers Prohibited; Administrative Violation
Section 415.006. Employer Chargebacks Prohibited; Administrative Violation
Section 415.007. Loans by Attorneys Prohibited
Section 415.008. Fraudulently Obtaining or Denying Benefits; Administrative Violation
Section 415.009. Frivolous Actions; Administrative Violation
Section 415.010. Breach of Agreement; Administrative Violation