Texas Statutes
Subchapter I. Relations With Physicians and Providers
Section 843.314. Inducement to Limit Medically Necessary Services Prohibited

Sec. 843.314. INDUCEMENT TO LIMIT MEDICALLY NECESSARY SERVICES PROHIBITED. (a) A health maintenance organization may not use a financial incentive or make a payment to a physician or provider if the incentive or payment acts directly or indirectly as an inducement to limit medically necessary services.
(b) This section does not prohibit the use of capitation as a method of payment.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.

Structure Texas Statutes

Title 6 - Organization of Insurers and Related Entities

Subtitle C - Life, Health, and Accident Insurers and Related Entities

Chapter 843 - Health Maintenance Organizations

Subchapter I. Relations With Physicians and Providers

Section 843.301. Practice of Medicine Not Affected

Section 843.302. Disclosure of Application Procedures and Qualification Requirements to Physician or Provider

Section 843.303. Denial of Initial Contract to Physician or Provider

Section 843.304. Exclusion of Provider Based on Type of License Prohibited

Section 843.3041. Acupuncturist Services

Section 843.3042. Chiropractic Services

Section 843.3045. Nurse First Assistant

Section 843.305. Annual Application Period for Physicians and Providers to Contract

Section 843.306. Termination of Participation; Advisory Review Panel

Section 843.307. Expedited Review Process on Termination or Deselection

Section 843.308. Notification of Patients of Deselected Physician or Provider

Section 843.309. Contracts With Physicians or Providers: Notice to Certain Enrollees of Termination of Physician or Provider Participation in Plan

Section 843.310. Contracts With Physicians or Providers: Certain Indemnity Clauses Prohibited

Section 843.311. Contracts With Podiatrists

Section 843.3115. Contracts With Dentists

Section 843.312. Physician Assistants and Advanced Practice Nurses

Section 843.313. Economic Profiling

Section 843.314. Inducement to Limit Medically Necessary Services Prohibited

Section 843.315. Payment of Capitation; Assignment of Primary Care Physician or Provider

Section 843.316. Alternative Capitation System

Section 843.317. Exclusion of Physician or Provider Based on Affiliation With Health Maintenance Organization Prohibited

Section 843.318. Certain Contracts of Participating Physician or Provider Not Prohibited

Section 843.319. Certain Required Contracts

Section 843.320. Use of Hospitalist

Section 843.321. Availability of Coding Guidelines

Section 843.323. Contract Provisions Prohibiting Rejection of Batched Claims