Section 3.9805 - Express Authority(a) Except as provided in subsection (c) of this section, the grant of express authority of a provider for access to their fee schedules cannot be presumed for any line of business for the purposes of compliance with Insurance Code § 1458.101.(b) The contracting entity must notify the provider about all applicable fee schedules, but such notification is not to be, and must not be, construed as: (1) prohibiting a provider network contracting entity from only contracting with providers who agree to all fee schedules; or(2) requiring providers to agree to all fee schedules.(c) For purposes of compliance with Insurance Code § 1458.101, a provider's express authority is presumed if: (1) the provider network contract is in existence before September 1, 2013;(2) on the first renewal after September 1, 2013, the contracting entity sends a written renewal notice by United States mail to the provider;(3) the notice described by paragraph (2) of this subsection: (A) contains a statement that failure to timely respond serves as assent to the renewal;(B) contains separate signature lines for each line of business applicable to the contract; and(C) specifies the separate fee schedule for each line of business applicable to the contract, described in any reasonable manner and which may be provided electronically; and(4) the provider fails to respond within 60 days of receipt of the notice and has not objected to the renewal.28 Tex. Admin. Code § 3.9805
Adopted by Texas Register, Volume 39, Number 46, November 14, 2014, TexReg 9020, eff. 11/19/2014