Section 1452.206 - Effect of Failure to Meet Credentialing Requirements If, on completion of the credentialing process, the managed care plan issuer determines that the applicant therapeutic optometrist does not meet the issuer's credentialing requirements:
(1) the managed care plan issuer may recover from the applicant therapeutic optometrist or the therapeutic optometrist's professional practice an amount equal to the difference between payments for in-network benefits and out-of-network benefits; and(2) the applicant therapeutic optometrist or the therapeutic optometrist's professional practice may retain any copayments collected or in the process of being collected as of the date of the issuer's determination.Tex. Ins. Code § 1452.206
Added by Acts 2013, 83rd Leg. - Regular Session, ch. 79,Sec. 1, eff. 9/1/2013.