Current with legislation from the 2023 Regular and Special Sessions signed by the Governor as of November 21, 2023.
Section 1217.002 - [Effective Until 4/1/2025] Applicability of Chapter(a) This chapter applies only to a health benefit plan that provides benefits for medical or surgical expenses incurred as a result of a health condition, accident, or sickness, including an individual, group, blanket, or franchise insurance policy or insurance agreement, a group hospital service contract, or a small or large employer group contract or similar coverage document that is offered by: (1) an insurance company;(2) a group hospital service corporation operating under Chapter 842;(3) a fraternal benefit society operating under Chapter 885;(4) a stipulated premium company operating under Chapter 884;(5) a reciprocal exchange operating under Chapter 942;(6) a health maintenance organization operating under Chapter 843;(7) a multiple employer welfare arrangement that holds a certificate of authority under Chapter 846; or(8) an approved nonprofit health corporation that holds a certificate of authority under Chapter 844.(b) This chapter applies to group health coverage made available by a school district in accordance with Section 22.004, Education Code.(c) Notwithstanding any provision in Chapter 1551, 1575, 1579, or 1601 or any other law, this chapter applies to: (1) a basic coverage plan under Chapter 1551;(2) a basic plan under Chapter 1575;(3) a primary care coverage plan under Chapter 1579; and(4) basic coverage under Chapter 1601.(d) Notwithstanding any other law, this chapter applies to coverage under: (1) the child health plan program under Chapter 62, Health and Safety Code, or the health benefits plan for children under Chapter 63, Health and Safety Code; and(2) a Medicaid managed care program operated under Chapter 533, Government Code, or a Medicaid program operated under Chapter 32, Human Resources Code.Tex. Ins. Code § 1217.002
Added by Acts 2013, 83rd Leg. - Regular Session, ch. 1198,Sec. 1, eff. 9/1/2013, op. for a request for prior authorization of health care services made on or after September 1, 2015.This section is set out more than once due to postponed, multiple, or conflicting amendments.