Tex. Ins. Code Section 38.355
Data Call; Standardized Format


Each health benefit plan issuer shall submit to the department, at the time and in the form and manner required by the department, aggregate reimbursement rates by region paid by the health benefit plan issuer for health care services identified by the department.


The department shall require that data submitted under this section be submitted in a standardized format, established by rule, to permit comparison of health care reimbursement rates. To the extent feasible, the department shall develop the data submission requirements in a manner that allows collection of reimbursement rates as a dollar amount and not by comparison to other standard reimbursement rates, such as Medicare reimbursement rates.


The department shall specify the period for which reimbursement rates must be filed under this section.


The department may contract with a private third party to obtain the data under this subchapter. If the department contracts with a third party, the department may determine the aggregate data to be collected and published under Section 38.357 (Publication of Aggregate Health Care Reimbursement Rate Information) if consistent with the purposes of this subchapter described in Section 38.351 (Purpose of Subchapter). The department shall prohibit the third party contractor from selling, leasing, or publishing the data obtained by the contractor under this subchapter.
Added by Acts 2007, 80th Leg., R.S., Ch. 997 (S.B. 1731), Sec. 8, eff. September 1, 2007.

Source: Section 38.355 — Data Call; Standardized Format, https://statutes.­capitol.­texas.­gov/Docs/IN/htm/IN.­38.­htm#38.­355 (accessed Jun. 5, 2024).

Jun. 5, 2024

§ 38.355’s source at texas​.gov