Section 21.2414 - Source-of-Injury Exclusions(a) No denial of benefits. If a health benefit plan generally provides benefits for a type of injury, the plan may not deny benefits otherwise provided for treatment of the injury if the injury results from an act of domestic violence or a medical condition (including both physical and mental health conditions). This rule applies in the case of an injury resulting from a medical condition even if the condition is not diagnosed before the injury.(b) Example. The requirements of subsection (a) of this section are illustrated by the example in figure 28 TAC § 21.2414(b). Attached Graphic
28 Tex. Admin. Code § 21.2414
Adopted by Texas Register, Volume 46, Number 36, September 3, 2021, TexReg 5579, eff. 9/7/2021