Texas Statutes
Title 8 - Health Insurance and Other Health Coverages
Subtitle E - Benefits Payable Under Health Coverages

Section 1351.006. Reimbursement for Home Health Services: Physician Certification Required - Sec. 1351.006. REIMBURSEMENT FOR HOME HEALTH SERVICES: PHYSICIAN CERTIFICATION REQUIRED....

Section 1351.007. Limitations and Exclusions on Coverage Permitted - Sec. 1351.007. LIMITATIONS AND EXCLUSIONS ON COVERAGE PERMITTED. (a) A...

Section 1351.008. Rejection of Coverage by Plan Holder; Negotiation of Alternative Coverage - Sec. 1351.008. REJECTION OF COVERAGE BY PLAN HOLDER; NEGOTIATION OF...

Section 1351.009. Additional Coverage Not Precluded - Sec. 1351.009. ADDITIONAL COVERAGE NOT PRECLUDED. This chapter does not...

Chapter 1352 - Brain Injury

Section 1352.001. Applicability of Chapter - Sec. 1352.001. APPLICABILITY OF CHAPTER. (a) This chapter applies only...

Section 1352.002. Exception; Application to Qualified Health Plan - Sec. 1352.002. EXCEPTION; APPLICATION TO QUALIFIED HEALTH PLAN. (a) This...

Section 1352.003. Required Coverages--Health Benefit Plans Other Than Small Employer Health Benefit Plans - Sec. 1352.003. REQUIRED COVERAGES--HEALTH BENEFIT PLANS OTHER THAN SMALL EMPLOYER...

Section 1352.0035. Required Coverages--Small Employer Health Benefit Plans - Sec. 1352.0035. REQUIRED COVERAGES--SMALL EMPLOYER HEALTH BENEFIT PLANS. (a) A...

Section 1352.004. Training for Certain Personnel Required - Sec. 1352.004. TRAINING FOR CERTAIN PERSONNEL REQUIRED. (a) In this...

Section 1352.005. Notice to Insureds and Enrollees - Sec. 1352.005. NOTICE TO INSUREDS AND ENROLLEES. (a) A health...

Section 1352.006. Determination of Medical Necessity; Extension of Coverage - Sec. 1352.006. DETERMINATION OF MEDICAL NECESSITY; EXTENSION OF COVERAGE. (a)...

Section 1352.007. Treatment Facilities - Sec. 1352.007. TREATMENT FACILITIES. (a) A health benefit plan may...

Section 1352.008. Consumer Information - Sec. 1352.008. CONSUMER INFORMATION. The commissioner shall prepare information for...

Chapter 1353 - Immunization or Vaccination Protocols Under Managed Care Plans

Section 1353.001. Prohibited Conduct - Sec. 1353.001. PROHIBITED CONDUCT. A managed care entity may not:...

Section 1353.002. Rules - Sec. 1353.002. RULES. The commissioner may adopt rules to implement...

Chapter 1354 - Eligibility for Benefits for Alzheimer's Disease

Section 1354.001. Applicability of Chapter - Sec. 1354.001. APPLICABILITY OF CHAPTER. This chapter applies only to...

Section 1354.002. Proof of Organic Disease - Sec. 1354.002. PROOF OF ORGANIC DISEASE. If a health benefit...

Chapter 1355 - Benefits for Certain Mental Disorders

Subchapter A. Group Health Benefit Plan Coverage

Section 1355.001. Definitions - Sec. 1355.001. DEFINITIONS. In this subchapter: (1) "Serious mental illness"...

Section 1355.002. Applicability of Subchapter - Sec. 1355.002. APPLICABILITY OF SUBCHAPTER. (a) This subchapter applies only...

Section 1355.003. Exception - Sec. 1355.003. EXCEPTION. (a) This subchapter does not apply to...

Section 1355.004. Required Coverage for Serious Mental Illness - Sec. 1355.004. REQUIRED COVERAGE FOR SERIOUS MENTAL ILLNESS. (a) A...

Section 1355.005. Managed Care Plan Authorized - Sec. 1355.005. MANAGED CARE PLAN AUTHORIZED. A group health benefit...

Section 1355.006. Coverage for Certain Conditions Related to Controlled Substance or Marihuana Not Required - Sec. 1355.006. COVERAGE FOR CERTAIN CONDITIONS RELATED TO CONTROLLED SUBSTANCE...

Section 1355.007. Small Employer Coverage - Sec. 1355.007. SMALL EMPLOYER COVERAGE. An issuer of a group...

Section 1355.015. Required Coverage for Certain Enrollees - Sec. 1355.015. REQUIRED COVERAGE FOR CERTAIN ENROLLEES. (a) At a...

Subchapter B. Alternative Mental Health Treatment Benefits

Section 1355.051. Definitions - Sec. 1355.051. DEFINITIONS. In this subchapter: (1) "Crisis stabilization unit"...

Section 1355.052. Applicability of Subchapter - Sec. 1355.052. APPLICABILITY OF SUBCHAPTER. This subchapter applies to a...

Section 1355.053. Required Coverage for Certain Illnesses and Disorders - Sec. 1355.053. REQUIRED COVERAGE FOR CERTAIN ILLNESSES AND DISORDERS. A...

Section 1355.054. Conditions for Coverage - Sec. 1355.054. CONDITIONS FOR COVERAGE. (a) Benefits of coverage provided...

Section 1355.055. Determinations for Treatment in a Residential Treatment Center for Children and Adolescents - Sec. 1355.055. DETERMINATIONS FOR TREATMENT IN A RESIDENTIAL TREATMENT CENTER...

Section 1355.056. Determinations for Treatment by a Crisis Stabilization Unit - Sec. 1355.056. DETERMINATIONS FOR TREATMENT BY A CRISIS STABILIZATION UNIT....

Section 1355.057. Review and Adjustment of Minimum Ratios of Reimbursement - Sec. 1355.057. REVIEW AND ADJUSTMENT OF MINIMUM RATIOS OF REIMBURSEMENT....

Section 1355.058. Assistance of the Texas Department of Mental Health and Mental Retardation - Sec. 1355.058. ASSISTANCE OF THE TEXAS DEPARTMENT OF MENTAL HEALTH...

Subchapter C. Psychiatric Day Treatment Facilities

Section 1355.101. Definition - Sec. 1355.101. DEFINITION. In this subchapter, "psychiatric day treatment facility"...

Section 1355.102. Applicability of Subchapter - Sec. 1355.102. APPLICABILITY OF SUBCHAPTER. This subchapter applies to a...

Section 1355.103. Applicability of General Provisions of Other Law - Sec. 1355.103. APPLICABILITY OF GENERAL PROVISIONS OF OTHER LAW. The...

Section 1355.104. Required Coverage for Treatment in Psychiatric Day Treatment Facility - Sec. 1355.104. REQUIRED COVERAGE FOR TREATMENT IN PSYCHIATRIC DAY TREATMENT...

Section 1355.105. Determinations for Treatment in Psychiatric Day Treatment Facility - Sec. 1355.105. DETERMINATIONS FOR TREATMENT IN PSYCHIATRIC DAY TREATMENT FACILITY....

Section 1355.106. Offer of Coverage Required; Alternative Benefits - Sec. 1355.106. OFFER OF COVERAGE REQUIRED; ALTERNATIVE BENEFITS. (a) An...

Subchapter D. Certain Coverages Provided by Local Governments

Section 1355.151. Prohibition on Exclusion or Limitation of Certain Coverages - Sec. 1355.151. PROHIBITION ON EXCLUSION OR LIMITATION OF CERTAIN COVERAGES....

Subchapter E. Benefits for Treatment by Tax-Supported Institution

Section 1355.201. Applicability of General Provisions of Other Law - Sec. 1355.201. APPLICABILITY OF GENERAL PROVISIONS OF OTHER LAW. The...

Section 1355.202. Prohibition of Exclusion of Mental Health or Mental Retardation Benefits for Treatment by Tax-Supported Institution - Sec. 1355.202. PROHIBITION OF EXCLUSION OF MENTAL HEALTH OR MENTAL...

Subchapter F. Coverage for Mental Health Conditions and Substance Use Disorders

Section 1355.251. Definitions - Sec. 1355.251. DEFINITIONS. In this subchapter: (1) "Mental health benefit"...

Section 1355.252. Applicability of Subchapter - Sec. 1355.252. APPLICABILITY OF SUBCHAPTER. (a) This subchapter applies only...

Section 1355.253. Exceptions - Sec. 1355.253. EXCEPTIONS. (a) This subchapter does not apply to:...

Section 1355.254. Coverage for Mental Health Conditions and Substance Use Disorders - Sec. 1355.254. COVERAGE FOR MENTAL HEALTH CONDITIONS AND SUBSTANCE USE...

Section 1355.255. Compliance - Sec. 1355.255. COMPLIANCE. The commissioner shall enforce compliance with Section...

Section 1355.256. Definitions Under Plan - Sec. 1355.256. DEFINITIONS UNDER PLAN. (a) A health benefit plan...

Section 1355.257. Coordination With Other Law; Intent of Legislature - Sec. 1355.257. COORDINATION WITH OTHER LAW; INTENT OF LEGISLATURE. This...

Section 1355.2571. Parity Complaint Portal - Sec. 1355.2571. PARITY COMPLAINT PORTAL. (a) The commissioner shall develop...

Section 1355.2572. Educational Materials and Parity Law Training; Report - Sec. 1355.2572. EDUCATIONAL MATERIALS AND PARITY LAW TRAINING; REPORT. (a)...

Section 1355.258. Rules - Sec. 1355.258. RULES. The commissioner shall adopt rules necessary to...

Chapter 1356 - Mammography and Other Breast Imaging

Section 1356.001. Definitions - Sec. 1356.001. DEFINITIONS. In this chapter: (1) "Breast tomosynthesis" means...

Section 1356.002. Applicability of Chapter - Sec. 1356.002. APPLICABILITY OF CHAPTER. (a) This chapter applies to...

Section 1356.003. Applicability of General Provisions of Other Law - Sec. 1356.003. APPLICABILITY OF GENERAL PROVISIONS OF OTHER LAW. The...

Section 1356.004. Exception - Sec. 1356.004. EXCEPTION. This chapter does not apply to a...

Section 1356.005. Coverage Required - Sec. 1356.005. COVERAGE REQUIRED. (a) A health benefit plan that...

Chapter 1357 - Mastectomy

Subchapter A. Reconstructive Surgery Following Mastectomy

Section 1357.001. Definitions - Sec. 1357.001. DEFINITIONS. In this subchapter: (1) "Breast reconstruction" means...

Section 1357.002. Applicability of Subchapter - Sec. 1357.002. APPLICABILITY OF SUBCHAPTER. This subchapter applies only to...

Section 1357.003. Exception - Sec. 1357.003. EXCEPTION. This subchapter does not apply to: (1)...

Section 1357.004. Coverage Required - Sec. 1357.004. COVERAGE REQUIRED. (a) A health benefit plan that...

Section 1357.005. Prohibited Conduct - Sec. 1357.005. PROHIBITED CONDUCT. (a) An issuer of a health...

Section 1357.006. Notice of Coverage - Sec. 1357.006. NOTICE OF COVERAGE. (a) An issuer of a...

Section 1357.007. Rules - Sec. 1357.007. RULES. The commissioner may adopt rules to implement...

Subchapter B. Hospital Stay Following Mastectomy and Certain Related Procedures

Section 1357.051. Definition - Sec. 1357.051. DEFINITION. In this subchapter, "enrollee" means an individual...

Section 1357.052. Applicability of Subchapter - Sec. 1357.052. APPLICABILITY OF SUBCHAPTER. This subchapter applies only to...

Section 1357.053. Exception - Sec. 1357.053. EXCEPTION. This subchapter does not apply to: (1)...

Section 1357.054. Coverage Required - Sec. 1357.054. COVERAGE REQUIRED. (a) A health benefit plan that...

Section 1357.055. Prohibited Conduct - Sec. 1357.055. PROHIBITED CONDUCT. An issuer of a health benefit...

Section 1357.056. Notice of Coverage - Sec. 1357.056. NOTICE OF COVERAGE. (a) An issuer of a...

Section 1357.057. Rules - Sec. 1357.057. RULES. The commissioner shall adopt rules necessary to...

Chapter 1358 - Diabetes

Subchapter A. Guidelines for Diabetes Care; Minimum Coverage Required

Section 1358.001. Definition - Sec. 1358.001. DEFINITION. In this subchapter, "enrollee" means an individual...

Section 1358.002. Applicability of Subchapter - Sec. 1358.002. APPLICABILITY OF SUBCHAPTER. This subchapter applies only to...

Section 1358.003. Exception - Sec. 1358.003. EXCEPTION. This subchapter does not apply to: (1)...

Section 1358.004. Adoption of Minimum Standards - Sec. 1358.004. ADOPTION OF MINIMUM STANDARDS. The commissioner, in consultation...

Section 1358.005. Coverage Required - Sec. 1358.005. COVERAGE REQUIRED. (a) A health benefit plan must...

Subchapter B. Supplies and Services Associated With Diabetes Treatment

Section 1358.051. Definitions - Sec. 1358.051. DEFINITIONS. In this subchapter: (1) "Diabetes equipment" means:...

Section 1358.052. Applicability of Subchapter - Sec. 1358.052. APPLICABILITY OF SUBCHAPTER. This subchapter applies only to...

Section 1358.053. Exception - Sec. 1358.053. EXCEPTION. This subchapter does not apply to: (1)...

Section 1358.054. Coverage Required - Sec. 1358.054. COVERAGE REQUIRED. (a) A health benefit plan that...

Section 1358.055. Diabetes Self-Management Training - Sec. 1358.055. DIABETES SELF-MANAGEMENT TRAINING. (a) Diabetes self-management training must...

Section 1358.056. Coverage for New or Improved Equipment and Supplies - Sec. 1358.056. COVERAGE FOR NEW OR IMPROVED EQUIPMENT AND SUPPLIES....

Section 1358.057. Rules - Sec. 1358.057. RULES. (a) The commissioner shall adopt rules necessary...

Subchapter C. Cost-Sharing Limit

Section 1358.101. Applicability of Subchapter - Sec. 1358.101. APPLICABILITY OF SUBCHAPTER. (a) This subchapter applies only...

Section 1358.102. Exception - Sec. 1358.102. EXCEPTION. This subchapter does not apply to: (1)...

Section 1358.103. Limit on Cost-Sharing Requirement - Sec. 1358.103. LIMIT ON COST-SHARING REQUIREMENT. (a) In this section,...

Section 1358.104. Formulary Requirement - Sec. 1358.104. FORMULARY REQUIREMENT. A health benefit plan must include...

Chapter 1359 - Formulas for Individuals With Phenylketonuria or Other Heritable Diseases

Section 1359.001. Definitions - Sec. 1359.001. DEFINITIONS. In this chapter: (1) "Heritable disease" means...

Section 1359.002. Applicability of Chapter - Sec. 1359.002. APPLICABILITY OF CHAPTER. This chapter applies only to...

Section 1359.003. Coverage Required - Sec. 1359.003. COVERAGE REQUIRED. (a) A group health benefit plan...

Chapter 1360 - Diagnosis and Treatment Affecting Temporomandibular Joint

Section 1360.001. Definition - Sec. 1360.001. DEFINITION. In this chapter, "temporomandibular joint" includes the...

Section 1360.002. Applicability of Chapter - Sec. 1360.002. APPLICABILITY OF CHAPTER. This chapter applies only to...

Section 1360.003. Exception - Sec. 1360.003. EXCEPTION. This chapter does not apply to: (1)...

Section 1360.004. Coverage Required - Sec. 1360.004. COVERAGE REQUIRED. (a) A health benefit plan that...

Section 1360.005. Dental Services Coverage Not Required - Sec. 1360.005. DENTAL SERVICES COVERAGE NOT REQUIRED. (a) This chapter...

Chapter 1361 - Detection and Prevention of Osteoporosis

Section 1361.001. Definition - Sec. 1361.001. DEFINITION. In this chapter, "qualified enrollee" means an...

Section 1361.002. Applicability of Chapter - Sec. 1361.002. APPLICABILITY OF CHAPTER. This chapter applies only to...

Section 1361.003. Coverage Required - Sec. 1361.003. COVERAGE REQUIRED. A group health benefit plan must...

Chapter 1362 - Certain Tests for Detection of Prostate Cancer

Section 1362.001. Applicability of Chapter - Sec. 1362.001. APPLICABILITY OF CHAPTER. This chapter applies only to...

Section 1362.002. Exception - Sec. 1362.002. EXCEPTION. This chapter does not apply to: (1)...

Section 1362.003. Coverage Required - Sec. 1362.003. COVERAGE REQUIRED. (a) A health benefit plan that...

Section 1362.004. Notice of Coverage - Sec. 1362.004. NOTICE OF COVERAGE. (a) A health benefit plan...

Section 1362.005. Rules - Sec. 1362.005. RULES. The commissioner shall adopt rules necessary to...

Chapter 1363 - Certain Tests for Detection of Colorectal Cancer

Section 1363.001. Applicability of Chapter - Sec. 1363.001. APPLICABILITY OF CHAPTER. This chapter applies only to...

Section 1363.002. Exception - Sec. 1363.002. EXCEPTION. This chapter does not apply to: (1)...

Section 1363.003. Minimum Coverage Required - Sec. 1363.003. MINIMUM COVERAGE REQUIRED. (a) A health benefit plan...

Section 1363.004. Notice of Coverage - Sec. 1363.004. NOTICE OF COVERAGE. (a) A health benefit plan...

Section 1363.005. Rules - Sec. 1363.005. RULES. The commissioner shall adopt rules as necessary...

Chapter 1364 - Coverage Provisions Relating to Hiv, Aids, or HIV-Related Illnesses

Subchapter A. Exclusion From or Denial of Coverage Prohibited

Section 1364.001. Applicability of Subchapter - Sec. 1364.001. APPLICABILITY OF SUBCHAPTER. This subchapter applies only to...

Section 1364.002. Exception - Sec. 1364.002. EXCEPTION. This subchapter does not apply to: (1)...

Section 1364.003. Prohibition - Sec. 1364.003. PROHIBITION. A group health benefit plan may not...

Section 1364.004. Rules - Sec. 1364.004. RULES. The commissioner may adopt rules necessary to...

Subchapter B. Cancellation of Group Coverage Prohibited

Section 1364.051. Definitions - Sec. 1364.051. DEFINITIONS. In this subchapter, "AIDS" and "HIV" have...

Section 1364.052. Applicability of Subchapter - Sec. 1364.052. APPLICABILITY OF SUBCHAPTER. This subchapter applies to an...

Section 1364.053. Prohibition - Sec. 1364.053. PROHIBITION. (a) Except as provided by Subsection (b),...

Subchapter C. Certain Coverages Provided by Local Governments

Section 1364.101. Prohibition on Exclusion or Limitation of Coverages - Sec. 1364.101. PROHIBITION ON EXCLUSION OR LIMITATION OF COVERAGES. A...

Chapter 1365 - Loss or Impairment of Speech or Hearing

Section 1365.001. Applicability of Chapter - Sec. 1365.001. APPLICABILITY OF CHAPTER. This chapter applies only to...

Section 1365.002. Applicability of General Provisions of Other Law - Sec. 1365.002. APPLICABILITY OF GENERAL PROVISIONS OF OTHER LAW. The...

Section 1365.003. Offer of Coverage Required - Sec. 1365.003. OFFER OF COVERAGE REQUIRED. (a) A group health...

Section 1365.004. Right to Reject Coverage or Select Alternative Benefits - Sec. 1365.004. RIGHT TO REJECT COVERAGE OR SELECT ALTERNATIVE BENEFITS....

Chapter 1366 - Benefits Related to Fertility and Childbirth

Subchapter A. Coverage for in Vitro Fertilization Procedures

Section 1366.001. Applicability of Subchapter - Sec. 1366.001. APPLICABILITY OF SUBCHAPTER. This subchapter applies only to...

Section 1366.002. Exception - Sec. 1366.002. EXCEPTION. This subchapter does not apply to: (1)...

Section 1366.003. Offer of Coverage Required - Sec. 1366.003. OFFER OF COVERAGE REQUIRED. (a) Subject to this...

Section 1366.004. Rejection of Offer - Sec. 1366.004. REJECTION OF OFFER. A rejection of an offer...

Section 1366.005. Conditions Applicable to Coverage - Sec. 1366.005. CONDITIONS APPLICABLE TO COVERAGE. The coverage offered under...

Section 1366.006. Certain Issuers of Health Benefit Plans Not Required to Offer Coverage - Sec. 1366.006. CERTAIN ISSUERS OF HEALTH BENEFIT PLANS NOT REQUIRED...

Section 1366.007. Rules - Sec. 1366.007. RULES. The commissioner may adopt rules necessary to...

Subchapter B. Minimum Inpatient Stay Following Birth of Child and Postdelivery Care

Section 1366.051. Short Title - Sec. 1366.051. SHORT TITLE. This subchapter may be cited as...

Section 1366.052. Definitions - Sec. 1366.052. DEFINITIONS. In this subchapter: (1) "Attending physician" means...

Section 1366.053. Applicability of Subchapter - Sec. 1366.053. APPLICABILITY OF SUBCHAPTER. This subchapter applies only to...

Section 1366.054. Exception - Sec. 1366.054. EXCEPTION. This subchapter does not apply to: (1)...

Section 1366.055. Coverage for Inpatient Care Required - Sec. 1366.055. COVERAGE FOR INPATIENT CARE REQUIRED. (a) Except as...

Section 1366.056. Coverage for Postdelivery Care Required - Sec. 1366.056. COVERAGE FOR POSTDELIVERY CARE REQUIRED. (a) If a...

Section 1366.057. Prohibited Conduct - Sec. 1366.057. PROHIBITED CONDUCT. An issuer of a health benefit...

Section 1366.058. Notice of Coverage - Sec. 1366.058. NOTICE OF COVERAGE. (a) An issuer of a...

Section 1366.059. Rules - Sec. 1366.059. RULES. The commissioner shall adopt rules necessary to...

Chapter 1367 - Coverage of Children

Subchapter A. Newborn Children

Section 1367.001. Applicability of Subchapter - Sec. 1367.001. APPLICABILITY OF SUBCHAPTER. This subchapter applies only to...

Section 1367.002. Applicability of General Provisions of Other Law - Sec. 1367.002. APPLICABILITY OF GENERAL PROVISIONS OF OTHER LAW. The...

Section 1367.003. Certain Limitations on Coverage for Newborn Children Prohibited - Sec. 1367.003. CERTAIN LIMITATIONS ON COVERAGE FOR NEWBORN CHILDREN PROHIBITED....

Subchapter B. Childhood Immunizations

Section 1367.051. Applicability of Subchapter - Sec. 1367.051. APPLICABILITY OF SUBCHAPTER. This subchapter applies only to...

Section 1367.052. Exception - Sec. 1367.052. EXCEPTION. This subchapter does not apply to: (1)...

Section 1367.053. Coverage Required - Sec. 1367.053. COVERAGE REQUIRED. (a) A health benefit plan that...

Section 1367.054. Copayment, Deductible, or Coinsurance Requirement Prohibited - Sec. 1367.054. COPAYMENT, DEDUCTIBLE, OR COINSURANCE REQUIREMENT PROHIBITED. (a) Coverage...

Section 1367.055. Rules - Sec. 1367.055. RULES. The commissioner may adopt rules necessary to...

Subchapter C. Hearing Test

Section 1367.101. Applicability of Subchapter - Sec. 1367.101. APPLICABILITY OF SUBCHAPTER. (a) This subchapter applies only...

Section 1367.102. Exception - Sec. 1367.102. EXCEPTION. This subchapter does not apply to: (1)...

Section 1367.103. Coverage Required - Sec. 1367.103. COVERAGE REQUIRED. (a) A health benefit plan that...

Section 1367.104. Copayment or Coinsurance Requirement Permitted; Deductible Requirement or Dollar Limit Prohibited; Notice Required - Sec. 1367.104. COPAYMENT OR COINSURANCE REQUIREMENT PERMITTED; DEDUCTIBLE REQUIREMENT OR...

Section 1367.105. Rules - Sec. 1367.105. RULES. The commissioner may adopt rules necessary to...

Subchapter D. Child Craniofacial Abnormalities

Section 1367.151. Applicability of Subchapter - Sec. 1367.151. APPLICABILITY OF SUBCHAPTER. This subchapter applies only to...

Section 1367.152. Exception - Sec. 1367.152. EXCEPTION. This subchapter does not apply to: (1)...

Section 1367.153. Reconstructive Surgery for Craniofacial Abnormalities; Definition Required - Sec. 1367.153. RECONSTRUCTIVE SURGERY FOR CRANIOFACIAL ABNORMALITIES; DEFINITION REQUIRED. A...

Section 1367.154. Rules - Sec. 1367.154. RULES. The commissioner shall adopt rules necessary to...

Subchapter E. Developmental Delays

Section 1367.201. Definition - Sec. 1367.201. DEFINITION. In this subchapter, rehabilitative and habilitative therapies...

Section 1367.202. Applicability of Subchapter - Sec. 1367.202. APPLICABILITY OF SUBCHAPTER. This subchapter applies only to...

Section 1367.203. Exception - Sec. 1367.203. EXCEPTION. This subchapter does not apply to: (1)...

Section 1367.204. Offer of Coverage Required - Sec. 1367.204. OFFER OF COVERAGE REQUIRED. (a) A health benefit...

Section 1367.205. Coverage of Certain Therapies - Sec. 1367.205. COVERAGE OF CERTAIN THERAPIES. (a) A health benefit...

Section 1367.206. Prohibited Actions - Sec. 1367.206. PROHIBITED ACTIONS. Under the coverage required to be...

Section 1367.207. Rules - Sec. 1367.207. RULES. The commissioner may adopt rules necessary to...

Subchapter F. Hearing AIDS and Cochlear Implants

Section 1367.251. Applicability of Subchapter - Sec. 1367.251. APPLICABILITY OF SUBCHAPTER. (a) This subchapter applies only...

Section 1367.252. Exception - Sec. 1367.252. EXCEPTION. This subchapter does not apply to: (1)...

Section 1367.253. Coverage Required - Sec. 1367.253. COVERAGE REQUIRED. (a) A health benefit plan must...

Chapter 1368 - Availability of Chemical Dependency Coverage

Section 1368.001. Definitions - Sec. 1368.001. DEFINITIONS. In this chapter: (1) "Chemical dependency" means...

Section 1368.002. Applicability of Chapter - Sec. 1368.002. APPLICABILITY OF CHAPTER. This chapter applies only to...

Section 1368.003. Exception - Sec. 1368.003. EXCEPTION. This chapter does not apply to: (1)...

Section 1368.004. Coverage Required - Sec. 1368.004. COVERAGE REQUIRED. (a) A group health benefit plan...

Section 1368.005. Minimum Coverage Requirements - Sec. 1368.005. MINIMUM COVERAGE REQUIREMENTS. (a) Except as provided by...

Section 1368.006. Limitation on Coverage - Sec. 1368.006. LIMITATION ON COVERAGE. (a) In this section, "treatment...

Section 1368.007. Treatment Standards - Sec. 1368.007. TREATMENT STANDARDS. (a) Coverage provided under this chapter...

Section 1368.008. Use of Endorsement or Rider to Comply With Chapter - Sec. 1368.008. USE OF ENDORSEMENT OR RIDER TO COMPLY WITH...

Chapter 1369 - Benefits Related to Prescription Drugs and Devices and Related Services

Subchapter A. Coverage of Prescription Drugs in General

Section 1369.001. Definitions - Sec. 1369.001. DEFINITIONS. In this subchapter: (1) "Contraindication" means the...

Section 1369.002. Applicability of Subchapter - Sec. 1369.002. APPLICABILITY OF SUBCHAPTER. This subchapter applies only to...

Section 1369.003. Exception - Sec. 1369.003. EXCEPTION. This subchapter does not apply to: (1)...

Section 1369.004. Coverage Required - Sec. 1369.004. COVERAGE REQUIRED. (a) A health benefit plan that...

Section 1369.0041. Certain Payments and Refills - Sec. 1369.0041. CERTAIN PAYMENTS AND REFILLS. (a) A health benefit...

Section 1369.005. Rules - Sec. 1369.005. RULES. The commissioner may adopt rules to implement...

Subchapter B. Coverage of Prescription Drugs Specified by Drug Formulary

Section 1369.051. Definitions - Sec. 1369.051. DEFINITIONS. In this subchapter: (1) "Clinical practice guideline"...

Section 1369.052. Applicability of Subchapter - Sec. 1369.052. APPLICABILITY OF SUBCHAPTER. This subchapter applies only to...

Section 1369.053. Exception - Sec. 1369.053. EXCEPTION. This subchapter does not apply to: (1)...

Section 1369.054. Notice and Disclosure of Certain Information Required - Sec. 1369.054. NOTICE AND DISCLOSURE OF CERTAIN INFORMATION REQUIRED. An...

Section 1369.0541. Modification of Drug Coverage Under Plan - Sec. 1369.0541. MODIFICATION OF DRUG COVERAGE UNDER PLAN. (a) A...

Section 1369.0545. Step Therapy Protocols - Sec. 1369.0545. STEP THERAPY PROTOCOLS. (a) A health benefit plan...

Section 1369.0546. Step Therapy Protocol Exception Requests - Sec. 1369.0546. STEP THERAPY PROTOCOL EXCEPTION REQUESTS. (a) A health...

Section 1369.055. Continuation of Coverage Required; Other Drugs Not Precluded - Sec. 1369.055. CONTINUATION OF COVERAGE REQUIRED; OTHER DRUGS NOT PRECLUDED....

Section 1369.056. Adverse Determination - Sec. 1369.056. ADVERSE DETERMINATION. (a) The refusal of a health...

Section 1369.057. Rules - Sec. 1369.057. RULES. The commissioner may adopt rules to implement...

Subchapter B. -1. Transparency Requirements for Certain Individual Health Benefit Plans

Section 1369.076. Definitions - Sec. 1369.076. DEFINITIONS. In this subchapter, terms defined by Subchapter...

Section 1369.077. Applicability of Subchapter - Sec. 1369.077. APPLICABILITY OF SUBCHAPTER. This subchapter applies only to...

Section 1369.078. Formulary Information on Internet Website - Sec. 1369.078. FORMULARY INFORMATION ON INTERNET WEBSITE. (a) A health...

Section 1369.079. Formulary Disclosure Requirements - Sec. 1369.079. FORMULARY DISCLOSURE REQUIREMENTS. (a) The commissioner shall develop...

Section 1369.080. Formulary Information Provided by Toll-Free Telephone Number - Sec. 1369.080. FORMULARY INFORMATION PROVIDED BY TOLL-FREE TELEPHONE NUMBER. In...

Subchapter C. Coverage of Prescription Contraceptive Drugs and Devices and Related Services

Section 1369.101. Definitions - Sec. 1369.101. DEFINITIONS. In this subchapter: (1) "Enrollee" means a...

Section 1369.102. Applicability of Subchapter - Sec. 1369.102. APPLICABILITY OF SUBCHAPTER. This subchapter applies only to...

Section 1369.103. Exception - Sec. 1369.103. EXCEPTION. This subchapter does not apply to: (1)...

Section 1369.104. Exclusion or Limitation Prohibited - Sec. 1369.104. EXCLUSION OR LIMITATION PROHIBITED. (a) A health benefit...

Section 1369.105. Certain Cost-Sharing Provisions Prohibited - Sec. 1369.105. CERTAIN COST-SHARING PROVISIONS PROHIBITED. (a) A health benefit...

Section 1369.106. Certain Waiting Periods Prohibited - Sec. 1369.106. CERTAIN WAITING PERIODS PROHIBITED. (a) A health benefit...

Section 1369.107. Prohibited Conduct - Sec. 1369.107. PROHIBITED CONDUCT. A health benefit plan issuer may...

Section 1369.108. Exemption for Entities Associated With Religious Organization - Sec. 1369.108. EXEMPTION FOR ENTITIES ASSOCIATED WITH RELIGIOUS ORGANIZATION. (a)...

Section 1369.109. Enforcement - Sec. 1369.109. ENFORCEMENT. A health benefit plan issuer that violates...

Subchapter D. Pharmacy Benefit Cards

Section 1369.151. Applicability of Subchapter - Sec. 1369.151. APPLICABILITY OF SUBCHAPTER. (a) This subchapter applies only...

Section 1369.152. Exception - Sec. 1369.152. EXCEPTION. This subchapter does not apply to: (1)...

Section 1369.153. Information Required on Identification Card - Sec. 1369.153. INFORMATION REQUIRED ON IDENTIFICATION CARD. (a) An issuer...

Section 1369.154. Rules - Sec. 1369.154. RULES. (a) The commissioner shall adopt rules as...

Subchapter E. Coverage for Orally Administered Anticancer Medications

Section 1369.201. Definitions - Sec. 1369.201. DEFINITIONS. In this subchapter: (1) "Health benefit exchange"...

Section 1369.202. Applicability of Subchapter - Sec. 1369.202. APPLICABILITY OF SUBCHAPTER. This subchapter applies only to...

Section 1369.203. Exception - Sec. 1369.203. EXCEPTION. (a) This subchapter does not apply to:...

Section 1369.204. Required Coverage for Orally Administered Anticancer Medications - Sec. 1369.204. REQUIRED COVERAGE FOR ORALLY ADMINISTERED ANTICANCER MEDICATIONS. (a)...

Subchapter E. -1. Coverage of Prescription Drugs for Stage-Four Advanced, Metastatic Cancer

Section 1369.211. Definitions - Sec. 1369.211. DEFINITIONS. In this subchapter: (1) "Associated conditions" means...

Section 1369.212. Applicability of Subchapter - Sec. 1369.212. APPLICABILITY OF SUBCHAPTER. (a) This subchapter applies only...

Section 1369.213. Prohibited Conduct - Sec. 1369.213. PROHIBITED CONDUCT. (a) A health benefit plan that...

Subchapter F. Audits of Pharmacists and Pharmacies

Section 1369.251. Definitions - Sec. 1369.251. DEFINITIONS. In this subchapter: (1) "Desk audit" means...

Section 1369.252. Exceptions to Applicability of Subchapter - Sec. 1369.252. EXCEPTIONS TO APPLICABILITY OF SUBCHAPTER. This subchapter does...

Section 1369.253. Conflict With Other Laws - Sec. 1369.253. CONFLICT WITH OTHER LAWS. If there is a...

Section 1369.254. Audit of Pharmacist or Pharmacy; Notice; General Provisions - Sec. 1369.254. AUDIT OF PHARMACIST OR PHARMACY; NOTICE; GENERAL PROVISIONS....

Section 1369.255. Completion of Audit - Sec. 1369.255. COMPLETION OF AUDIT. An audit of a claim...

Section 1369.256. Audit Requiring Professional Judgment - Sec. 1369.256. AUDIT REQUIRING PROFESSIONAL JUDGMENT. A health benefit plan...

Section 1369.257. Access to Pharmacy Area - Sec. 1369.257. ACCESS TO PHARMACY AREA. A health benefit plan...

Section 1369.258. Validation Using Certain Records Authorized - Sec. 1369.258. VALIDATION USING CERTAIN RECORDS AUTHORIZED. A pharmacist or...

Section 1369.2581. Audit Discrepancies; Wholesale Invoices - Sec. 1369.2581. AUDIT DISCREPANCIES; WHOLESALE INVOICES. (a) A health benefit...

Section 1369.259. Calculation of Recoupment; Use of Extrapolation Prohibited - Sec. 1369.259. CALCULATION OF RECOUPMENT; USE OF EXTRAPOLATION PROHIBITED. (a)...

Section 1369.260. Clerical or Recordkeeping Error; Fraud Allegation - Sec. 1369.260. CLERICAL OR RECORDKEEPING ERROR; FRAUD ALLEGATION. (a) An...

Section 1369.261. Access to Previous Audit Reports; Uniform Audit Standards - Sec. 1369.261. ACCESS TO PREVIOUS AUDIT REPORTS; UNIFORM AUDIT STANDARDS....

Section 1369.262. Compensation of Auditor - Sec. 1369.262. COMPENSATION OF AUDITOR. An individual performing an on-site...

Section 1369.263. Conclusion of Audit; Summary; Preliminary Audit Report - Sec. 1369.263. CONCLUSION OF AUDIT; SUMMARY; PRELIMINARY AUDIT REPORT. (a)...

Section 1369.264. Final Audit Report - Sec. 1369.264. FINAL AUDIT REPORT. Not later than the 120th...

Section 1369.265. Certain Audits Exempt From Deadlines - Sec. 1369.265. CERTAIN AUDITS EXEMPT FROM DEADLINES. A health benefit...

Section 1369.266. Recoupment and Interest Charged After Audit - Sec. 1369.266. RECOUPMENT AND INTEREST CHARGED AFTER AUDIT. (a) If...

Section 1369.267. Waiver Prohibited - Sec. 1369.267. WAIVER PROHIBITED. The provisions of this subchapter may...

Section 1369.268. Remedies Not Exclusive - Sec. 1369.268. REMEDIES NOT EXCLUSIVE. This subchapter may not be...

Section 1369.269. Enforcement; Rules - Sec. 1369.269. ENFORCEMENT; RULES. The commissioner may enforce this subchapter...

Section 1369.270. Legislative Declaration - Sec. 1369.270. LEGISLATIVE DECLARATION. Except as provided by Section 1369.252,...

Subchapter G. Standard Request Form for Prior Authorization of Prescription Drug Benefits

Section 1369.301. Definition - Sec. 1369.301. DEFINITION. In this subchapter, "prescription drug" has the...

Section 1369.302. Applicability of Subchapter - Sec. 1369.302. APPLICABILITY OF SUBCHAPTER. (a) This subchapter applies only...

Section 1369.303. Exception - Sec. 1369.303. EXCEPTION. This subchapter does not apply to: (1)...

Section 1369.304. Standard Form - Sec. 1369.304. STANDARD FORM. (a) The commissioner by rule shall:...

Section 1369.305. Advisory Committee on Uniform Prior Authorization Forms - Sec. 1369.305. ADVISORY COMMITTEE ON UNIFORM PRIOR AUTHORIZATION FORMS. (a)...

Section 1369.306. Failure to Use or Acknowledge Standard Form - Sec. 1369.306. FAILURE TO USE OR ACKNOWLEDGE STANDARD FORM. If...

Subchapter H. Maximum Allowable Cost

Section 1369.351. Definitions - Sec. 1369.351. DEFINITIONS. In this subchapter: (1) "Health benefit plan"...

Section 1369.352. Certain Benefits Excluded - Sec. 1369.352. CERTAIN BENEFITS EXCLUDED. This subchapter does not apply...

Section 1369.353. Criteria for Drugs on Maximum Allowable Cost Lists - Sec. 1369.353. CRITERIA FOR DRUGS ON MAXIMUM ALLOWABLE COST LISTS....

Section 1369.354. Formulation of Maximum Allowable Costs; Disclosures - Sec. 1369.354. FORMULATION OF MAXIMUM ALLOWABLE COSTS; DISCLOSURES. (a) In...

Section 1369.355. Updates - Sec. 1369.355. UPDATES. (a) A health benefit plan issuer or...

Section 1369.356. Access to Maximum Allowable Cost Lists - Sec. 1369.356. ACCESS TO MAXIMUM ALLOWABLE COST LISTS. A health...

Section 1369.357. Appeal From Maximum Allowable Cost Price Determination - Sec. 1369.357. APPEAL FROM MAXIMUM ALLOWABLE COST PRICE DETERMINATION. (a)...

Section 1369.358. Confidentiality of Maximum Allowable Cost List - Sec. 1369.358. CONFIDENTIALITY OF MAXIMUM ALLOWABLE COST LIST. A maximum...

Section 1369.359. Waiver Prohibited - Sec. 1369.359. WAIVER PROHIBITED. The provisions of this subchapter may...

Section 1369.360. Remedies Not Exclusive - Sec. 1369.360. REMEDIES NOT EXCLUSIVE. This subchapter may not be...

Section 1369.361. Enforcement - Sec. 1369.361. ENFORCEMENT. The commissioner shall enforce this subchapter. Added...

Section 1369.362. Legislative Declaration - Sec. 1369.362. LEGISLATIVE DECLARATION. It is the intent of the...

Subchapter I. Pharmacy Benefit Claim Adjudication

Section 1369.401. Definition - Sec. 1369.401. DEFINITION. In this subchapter, "pharmacy benefit manager" has...

Section 1369.402. Certain Fees Prohibited - Sec. 1369.402. CERTAIN FEES PROHIBITED. A health benefit plan issuer...

Subchapter J. Coverage Related to Prescription Drug Synchronization

Section 1369.451. Definitions - Sec. 1369.451. DEFINITIONS. In this subchapter: (1) "Cost-sharing amount" includes...

Section 1369.452. Applicability of Subchapter - Sec. 1369.452. APPLICABILITY OF SUBCHAPTER. (a) This subchapter applies only...

Section 1369.453. Applicability to Certain Medications - Sec. 1369.453. APPLICABILITY TO CERTAIN MEDICATIONS. This subchapter applies with...

Section 1369.454. Proration of Cost-Sharing Amount Required - Sec. 1369.454. PRORATION OF COST-SHARING AMOUNT REQUIRED. (a) A health...

Section 1369.455. Proration of Dispensing Fee Prohibited - Sec. 1369.455. PRORATION OF DISPENSING FEE PROHIBITED. A health benefit...

Section 1369.456. Implementation of Certain Medication Synchronization Plans - Sec. 1369.456. IMPLEMENTATION OF CERTAIN MEDICATION SYNCHRONIZATION PLANS. (a) For...

Subchapter K. Prescription Drug Cost Transparency

Section 1369.501. Definitions - Sec. 1369.501. DEFINITIONS. In this subchapter: (1) "Animal health product"...

Section 1369.502. Pharmacy Benefit Manager Information - Sec. 1369.502. PHARMACY BENEFIT MANAGER INFORMATION. (a) Not later than...

Section 1369.503. Health Benefit Plan Issuer Information - Sec. 1369.503. HEALTH BENEFIT PLAN ISSUER INFORMATION. (a) Not later...

Section 1369.5035. Content of Reports - Sec. 1369.5035. CONTENT OF REPORTS. The reports required by Sections...

Section 1369.504. Rules - Sec. 1369.504. RULES. The commissioner may adopt rules to implement...

Subchapter L. Contracts With Pharmacists and Pharmacies

Section 1369.551. Definitions - Sec. 1369.551. DEFINITIONS. In this subchapter: (1) "Pharmacy benefit manager"...

Section 1369.552. Applicability of Subchapter - Sec. 1369.552. APPLICABILITY OF SUBCHAPTER. (a) This subchapter applies only...

Section 1369.553. Reduction of Certain Claim Payment Amounts Prohibited - Sec. 1369.553. REDUCTION OF CERTAIN CLAIM PAYMENT AMOUNTS PROHIBITED. (a)...

Section 1369.554. Reimbursement of Affiliated and Nonaffiliated Pharmacists and Pharmacies - Sec. 1369.554. REIMBURSEMENT OF AFFILIATED AND NONAFFILIATED PHARMACISTS AND PHARMACIES....

Section 1369.555. Network Contract Fee Schedule - Sec. 1369.555. NETWORK CONTRACT FEE SCHEDULE. A pharmacy benefit network...

Section 1369.556. Disclosure of Pharmacy Services Administrative Organization Contract - Sec. 1369.556. DISCLOSURE OF PHARMACY SERVICES ADMINISTRATIVE ORGANIZATION CONTRACT. A...

Section 1369.557. Delivery of Drugs - Sec. 1369.557. DELIVERY OF DRUGS. (a) Except in a case...

Section 1369.558. Professional Standards and Scope of Practice Requirements - Sec. 1369.558. PROFESSIONAL STANDARDS AND SCOPE OF PRACTICE REQUIREMENTS. A...

Section 1369.559. Retaliation Prohibited - Sec. 1369.559. RETALIATION PROHIBITED. (a) A pharmacy benefit manager may...

Section 1369.560. Waiver Prohibited - Sec. 1369.560. WAIVER PROHIBITED. The provisions of this subchapter may...

Subchapter L. Affiliated Providers

Section 1369.551. Definitions - Sec. 1369.551. DEFINITIONS. In this subchapter: (1) "Affiliated provider" means...

Section 1369.552. Exceptions to Applicability of Subchapter - Sec. 1369.552. EXCEPTIONS TO APPLICABILITY OF SUBCHAPTER. Notwithstanding the definition...

Section 1369.553. Transfer or Acceptance of Certain Records Prohibited - Sec. 1369.553. TRANSFER OR ACCEPTANCE OF CERTAIN RECORDS PROHIBITED. (a)...

Section 1369.554. Prohibition on Certain Communications - Sec. 1369.554. PROHIBITION ON CERTAIN COMMUNICATIONS. (a) A health benefit...

Section 1369.555. Prohibition on Certain Referrals and Solicitations - Sec. 1369.555. PROHIBITION ON CERTAIN REFERRALS AND SOLICITATIONS. (a) A...

Chapter 1370 - Certain Tests for Detection of Human Papillomavirus, Ovarian Cancer, and Cervical Cancer

Section 1370.001. Applicability of Chapter - Sec. 1370.001. APPLICABILITY OF CHAPTER. (a) This chapter applies only...

Section 1370.002. Exceptions - Sec. 1370.002. EXCEPTIONS. (a) This chapter does not apply to:...

Section 1370.003. Coverage Required - Sec. 1370.003. COVERAGE REQUIRED. (a) A health benefit plan that...

Section 1370.004. Notice of Coverage - Sec. 1370.004. NOTICE OF COVERAGE. (a) A health benefit plan...

Chapter 1371 - Coverage for Certain Prosthetic Devices, Orthotic Devices, and Related Services

Section 1371.001. Definitions - Sec. 1371.001. DEFINITIONS. In this chapter: (1) "Enrollee" means an...

Section 1371.002. Applicability of Chapter - Sec. 1371.002. APPLICABILITY OF CHAPTER. (a) This chapter applies only...

Section 1371.003. Required Coverage for Prosthetic Devices, Orthotic Devices, and Related Services - Sec. 1371.003. REQUIRED COVERAGE FOR PROSTHETIC DEVICES, ORTHOTIC DEVICES, AND...

Section 1371.004. Preauthorization - Sec. 1371.004. PREAUTHORIZATION. A health benefit plan may require prior...

Section 1371.005. Managed Care Plan - Sec. 1371.005. MANAGED CARE PLAN. A health benefit plan provider...

Chapter 1376 - Certain Tests for Early Detection of Cardiovascular Disease

Section 1376.001. Applicability of Chapter - Sec. 1376.001. APPLICABILITY OF CHAPTER. (a) This chapter applies only...

Section 1376.002. Exceptions - Sec. 1376.002. EXCEPTIONS. This chapter does not apply to: (1)...

Section 1376.003. Minimum Coverage Required - Sec. 1376.003. MINIMUM COVERAGE REQUIRED. (a) A health benefit plan...

Chapter 1377 - Coverage for Certain Amino Acid-Based Elemental Formulas

Subchapter A. General Provisions

Section 1377.001. Definition - Sec. 1377.001. DEFINITION. In this chapter, "enrollee" means an individual...

Section 1377.002. Applicability of Chapter - Sec. 1377.002. APPLICABILITY OF CHAPTER. (a) This chapter applies only...

Section 1377.003. Exception - Sec. 1377.003. EXCEPTION. This chapter does not apply to: (1)...

Subchapter B. Coverage for Certain Amino Acid-Based Elemental Formulas

Section 1377.051. Required Coverage for Certain Amino Acid-Based Elemental Formulas - Sec. 1377.051. REQUIRED COVERAGE FOR CERTAIN AMINO ACID-BASED ELEMENTAL FORMULAS....

Section 1377.052. Utilization Review - Sec. 1377.052. UTILIZATION REVIEW. (a) A utilization review agent acting...

Chapter 1379 - Coverage for Routine Patient Care Costs for Enrollees Participating in Certain Clinical Trials

Subchapter A. General Provisions

Section 1379.001. Definitions - Sec. 1379.001. DEFINITIONS. In this chapter: (1) "Enrollee" means an...

Section 1379.002. Applicability of Chapter - Sec. 1379.002. APPLICABILITY OF CHAPTER. (a) This chapter applies only...

Section 1379.003. Applicability to Certain Government Programs - Sec. 1379.003. APPLICABILITY TO CERTAIN GOVERNMENT PROGRAMS. To the extent...

Section 1379.004. Exception - Sec. 1379.004. EXCEPTION. This chapter does not apply to: (1)...

Section 1379.005. Rules - Sec. 1379.005. RULES. The commissioner, in accordance with Subchapter A,...

Subchapter B. Coverage for Routine Patient Care Costs

Section 1379.051. Routine Patient Care Costs - Sec. 1379.051. ROUTINE PATIENT CARE COSTS. For purposes of this...

Section 1379.052. Coverage Required - Sec. 1379.052. COVERAGE REQUIRED. A health benefit plan issuer shall...

Section 1379.053. Research Institution - Sec. 1379.053. RESEARCH INSTITUTION. (a) A health benefit plan issuer...

Section 1379.054. Limitations on Coverage - Sec. 1379.054. LIMITATIONS ON COVERAGE. (a) Notwithstanding Section 1379.053, this...

Section 1379.055. Deductible, Coinsurance, and Copayment Requirements - Sec. 1379.055. DEDUCTIBLE, COINSURANCE, AND COPAYMENT REQUIREMENTS. The benefits required...

Section 1379.056. Cancellation or Nonrenewal Prohibited - Sec. 1379.056. CANCELLATION OR NONRENEWAL PROHIBITED. The issuer of a...

Chapter 1425 - Application of Subtitle to Certain Coverage

Subchapter A. Excepted Benefits

Section 1425.001. Exemption From Application of Subtitle - Sec. 1425.001. EXEMPTION FROM APPLICATION OF SUBTITLE. (a) Except as...

Section 1425.002. Specific Language Controls - Sec. 1425.002. SPECIFIC LANGUAGE CONTROLS. A provision of this subtitle...

Subchapter B. Benefits Requiring Defrayal

Section 1425.051. Definition - Sec. 1425.051. DEFINITION. In this subchapter, "qualified health plan" has...

Section 1425.052. Exemption From Subtitle for Benefits Requiring Defrayal - Sec. 1425.052. EXEMPTION FROM SUBTITLE FOR BENEFITS REQUIRING DEFRAYAL. (a)...

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Texas Statutes Title 8 - Health Insurance and Other Health Coverages Subtitle E - Benefits Payable Under Health Coverages

Texas Statutes
Title 8 - Health Insurance and Other Health Coverages
Subtitle E - Benefits Payable Under Health Coverages