Tex.
Ins. Code Section 1271.005
Applicability of Other Law
(a)
Chapters 1368 (Availability of Chemical Dependency Coverage) and 1652 (Medicare Supplement Benefit Plans) apply to a health maintenance organization other than a health maintenance organization that offers only a single health care service plan.(b)
Subchapter B (Definitions), Chapter 1355 (Benefits for Certain Mental Disorders), applies to a health maintenance organization providing benefits for mental health treatment in a residential treatment center for children and adolescents or crisis stabilization unit to the extent that:(1)
Subchapter B (Definitions), Chapter 1355 (Benefits for Certain Mental Disorders), does not conflict with this chapter, Chapter 843 (Health Maintenance Organizations), Subchapter A (Short Title), Chapter 1452 (Physician and Provider Credentials), or Subchapter B, Chapter 1507 (Consumer Choice of Benefits Plans); and(2)
the residential treatment center for children and adolescents or crisis stabilization unit is located within the service area of the health maintenance organization and is subject to inspection and review as required by this chapter, Chapter 843 (Health Maintenance Organizations), Subchapter A (Short Title), Chapter 1452 (Physician and Provider Credentials), or Subchapter B, Chapter 1507 (Consumer Choice of Benefits Plans), or rules adopted under this chapter, Chapter 843 (Health Maintenance Organizations), Subchapter A (Short Title), Chapter 1452 (Physician and Provider Credentials), or Subchapter B, Chapter 1507 (Consumer Choice of Benefits Plans).(c)
A health maintenance organization shall comply with Subchapter B (Definitions), Chapter 542 (Processing and Settlement of Claims), with respect to prompt payment to an enrollee.(d)
Notwithstanding any other law, Subchapter C (Definition), Chapter 1355 (Benefits for Certain Mental Disorders), applies to a group contract issued by a health maintenance organization.(e)
Notwithstanding any other law, Section 1201.062 (Coverage for Certain Children in Individual or Group Policy or in Plan or Program) applies to an evidence of coverage issued by a health maintenance organization.
Source:
Section 1271.005 — Applicability of Other Law, https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1271.htm#1271.005
(accessed Jun. 5, 2024).