Tex.
Ins. Code Section 843.111
Group Model Health Maintenance Organizations
(a)
In this section, “group model health maintenance organization” means a health maintenance organization that provides the majority of its professional services through a single group medical practice that is formally affiliated with the medical school component of a state-supported public college or university in this state.(b)
Unless this section and a power specified in Section 843.101 (Providing or Arranging for Care), 843.103 (Acquisition and Operation of Facilities; Certain Loans; Commissioner Approval of Affiliate Transactions), 843.104 (Contracts for Certain Administrative Functions), 843.106 (Insurance, Reinsurance, Indemnity, and Reimbursement), 843.107 (Indemnity Benefits; Point-of-service Provisions), 843.109 (Payment by Governmental or Private Entity), or 843.110 (Corporation, Partnership, or Association Powers) are specifically amended by law, a law, without regard to the time of enactment, may not be construed to prohibit or restrict a group model health maintenance organization from:(1)
selectively contracting with or declining to contract with a provider as the group model health maintenance organization considers necessary;(2)
contracting for or declining to contract for an individual health care service or full range of health care services as the group model health maintenance organization considers necessary, if the service or services may be legally provided by the contracting provider; or(3)
requiring enrolled members of the group model health maintenance organization who wish to obtain the services covered by the group model health maintenance organization to use the providers specified by the group model health maintenance organization.
Source:
Section 843.111 — Group Model Health Maintenance Organizations, https://statutes.capitol.texas.gov/Docs/IN/htm/IN.843.htm#843.111 (accessed Jun. 5, 2024).
