Tex.
Ins. Code Section 848.004
Applicability of Insurance Laws
(a)
An organization may not arrange for or provide health care services to enrollees on a prepaid or indemnity basis through health insurance or a health benefit plan, including a health care plan, as defined by Section 843.002 (Definitions), unless the organization as an insurer or health maintenance organization holds the appropriate certificate of authority issued under another chapter of this code.(b)
Except as provided by Subsection (c), the following provisions of this code apply to a health care collaborative in the same manner and to the same extent as they apply to an individual or entity otherwise subject to the provision:(1)
Section 38.001 (Inquiries);(2)
Subchapter A, Chapter 542 (Processing and Settlement of Claims);(3)
Chapter 541 (Unfair Methods of Competition and Unfair or Deceptive Acts or Practices);(4)
Chapter 543 (Prohibited Practices Related to Policy or Certificate of Membership);(5)
Chapter 602 (Privacy of Health Information);(6)
Chapter 701 (Insurance Fraud Investigations);(7)
Chapter 803 (Location of Books, Records, Accounts, and Offices Outside of This State); and(8)
Chapter 804 (Service of Process).(c)
The remedies available under this chapter in the manner provided by Chapter 541 (Unfair Methods of Competition and Unfair or Deceptive Acts or Practices) do not include:(1)
a private cause of action under Subchapter D, Chapter 541 (Unfair Methods of Competition and Unfair or Deceptive Acts or Practices); or(2)
a class action under Subchapter F, Chapter 541 (Unfair Methods of Competition and Unfair or Deceptive Acts or Practices).
Source:
Section 848.004 — Applicability of Insurance Laws, https://statutes.capitol.texas.gov/Docs/IN/htm/IN.848.htm#848.004 (accessed May 4, 2024).
