Tex.
Ins. Code Section 1461.001
Definitions
(1)
“Enrollee” means an individual who is eligible to receive health care services under a managed care plan.(2)
“Maintenance of certification” has the meaning assigned by Section 151.002 (Definitions), Occupations Code.(3)
“Managed care plan” means a health benefit plan under which health care services are provided to enrollees through contracts with physicians and that requires enrollees to use participating physicians or that provides a different level of coverage for enrollees who use participating physicians. The term includes a health benefit plan issued by:(A)
a health maintenance organization;(B)
a preferred provider benefit plan issuer; or(C)
any other entity that issues a health benefit plan, including an insurance company.(4)
“Participating physician” means a physician who has directly or indirectly contracted with a health benefit plan issuer to provide services to enrollees.(5)
“Physician” means an individual licensed to practice medicine in this state.
Source:
Section 1461.001 — Definitions, https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1461.htm#1461.001 (accessed May 26, 2025).
