Tex.
Ins. Code Section 848.002
Exception: Delegated Entities
(a)
This section applies only to an entity, other than a health maintenance organization, that:(1)
by itself or through a subcontract with another entity, undertakes to arrange for or provide medical care or health care services to enrollees in exchange for predetermined payments on a prospective basis; and(2)
accepts responsibility for performing functions that are required by:(A)
Chapter 222 (Life, Health, and Accident Insurance Premium Tax), 251 (General Provisions), 258 (Health Maintenance Organizations), or 1272 (Delegation of Certain Functions by Health Maintenance Organization), as applicable, to a health maintenance organization; or(B)
Chapter 843 (Health Maintenance Organizations), Chapter 1271 (Benefits Provided by Health Maintenance Organizations; Evidence of Coverage; Charges), Section 1367.053 (Coverage Required), Subchapter A, Chapter 1452 (Physician and Provider Credentials), or Subchapter B, Chapter 1507 (Consumer Choice of Benefits Plans), as applicable, solely on behalf of health maintenance organizations.(b)
An entity described by Subsection (a) is subject to Chapter 1272 (Delegation of Certain Functions by Health Maintenance Organization) and is not required to obtain a certificate of authority or determination of approval under this chapter.
Source:
Section 848.002 — Exception: Delegated Entities, https://statutes.capitol.texas.gov/Docs/IN/htm/IN.848.htm#848.002 (accessed May 4, 2024).
