Tex. Ins. Code Section 1355.2571
Parity Complaint Portal


(a)

The commissioner shall develop and maintain a parity complaint portal that is an integrated system that allows for the enrollee of a health benefit plan to submit complaints of suspected violations of the provisions of this subchapter. The parity complaint portal must:

(1)

allow for an enrollee to submit a complaint through multiple ways;

(2)

provide updates on the status of an enrollee’s complaint;

(3)

ensure timely, effective, and equitable resolution for submitted complaints;

(4)

include educational materials regarding:

(A)

benefits for mental health conditions and substance use disorders required under this subchapter;

(B)

an enrollee’s rights and responsibilities under a health benefit plan concerning coverage under this subchapter;

(C)

circumstances under which a claim may be denied; and

(D)

the processes for reviewing a complaint submitted through the portal;

(5)

adhere to national best practices as determined by the commissioner; and

(6)

include the findings of the report required by Section 1355.2572 (Educational Materials and Parity Law Training; Report)(b).

(b)

In developing the parity complaint portal under Subsection (a), the commissioner:

(1)

shall conduct an assessment of complaint portals and similar systems used by other relevant public or private entities;

(2)

shall develop best practice standards for complaint submissions and tracking consistent with the findings of the assessment conducted under Subdivision (1); and

(3)

may develop a new complaint portal or modify an existing complaint portal.

(c)

The Health and Human Services Commission shall appoint a liaison to the department to receive reports of concerns, complaints, and potential violations submitted through the parity complaint portal established under Subsection (a).
Added by Acts 2021, 87th Leg., R.S., Ch. 703 (H.B. 2595), Sec. 2, eff. September 1, 2021.

Source: Section 1355.2571 — Parity Complaint Portal, https://statutes.­capitol.­texas.­gov/Docs/IN/htm/IN.­1355.­htm#1355.­2571 (accessed Nov. 25, 2023).

1355.001
Definitions
1355.002
Applicability of Subchapter
1355.003
Exception
1355.004
Required Coverage for Serious Mental Illness
1355.005
Managed Care Plan Authorized
1355.006
Coverage for Certain Conditions Related to Controlled Substance or Marihuana Not Required
1355.007
Small Employer Coverage
1355.015
Required Coverage for Certain Enrollees
1355.051
Definitions
1355.052
Applicability of Subchapter
1355.053
Required Coverage for Certain Illnesses and Disorders
1355.054
Conditions for Coverage
1355.055
Determinations for Treatment in a Residential Treatment Center for Children and Adolescents
1355.056
Determinations for Treatment by a Crisis Stabilization Unit
1355.057
Review and Adjustment of Minimum Ratios of Reimbursement
1355.058
Health and Human Services Commission Assistance
1355.101
Definition
1355.102
Applicability of Subchapter
1355.103
Applicability of General Provisions of Other Law
1355.104
Required Coverage for Treatment in Psychiatric Day Treatment Facility
1355.105
Determinations for Treatment in Psychiatric Day Treatment Facility
1355.106
Offer of Coverage Required
1355.151
Prohibition on Exclusion or Limitation of Certain Coverages
1355.201
Applicability of General Provisions of Other Law
1355.202
Prohibition of Exclusion of Mental Health or Intellectual Disability Benefits for Treatment by Tax-supported Institution
1355.251
Definitions
1355.252
Applicability of Subchapter
1355.253
Exceptions
1355.254
Coverage for Mental Health Conditions and Substance Use Disorders
1355.255
Compliance
1355.256
Definitions Under Plan
1355.257
Coordination with Other Law
1355.258
Rules
1355.2571
Parity Complaint Portal
1355.2572
Educational Materials and Parity Law Training

Accessed:
Nov. 25, 2023

§ 1355.2571’s source at texas​.gov