Tex.
Ins. Code Section 848.201
Enforcement Actions
(a)
After notice and opportunity for a hearing, the commissioner may:(1)
suspend or revoke a certificate of authority issued to a health care collaborative under this chapter;(2)
impose sanctions under Chapter 82 (Sanctions);(3)
issue a cease and desist order under Chapter 83 (Emergency Cease and Desist Orders); or(4)
impose administrative penalties under Chapter 84 (Administrative Penalties).(b)
The commissioner may take an enforcement action listed in Subsection (a) against a health care collaborative if the commissioner finds that the health care collaborative:(1)
is operating in a manner that is:(A)
significantly contrary to its basic organizational documents; or(B)
contrary to the manner described in and reasonably inferred from other information submitted under Section 848.057 (Requirements for Approval of Application);(2)
does not meet the requirements of Section 848.057 (Requirements for Approval of Application);(3)
cannot fulfill its obligation to provide health care services as required under its contracts with governmental or private entities;(4)
does not meet the requirements of Chapter 1272 (Delegation of Certain Functions by Health Maintenance Organization), if applicable;(5)
has not implemented the complaint system required by Section 848.107 (Complaint Systems) in a manner to resolve reasonably valid complaints;(6)
has advertised or merchandised its services in an untrue, misrepresentative, misleading, deceptive, or unfair manner or a person on behalf of the health care collaborative has advertised or merchandised the health care collaborative’s services in an untrue, misrepresentative, misleading, deceptive, or untrue manner;(7)
has not complied substantially with this chapter or a rule adopted under this chapter;(8)
has not taken corrective action the commissioner considers necessary to correct a failure to comply with this chapter, any applicable provision of this code, or any applicable rule or order of the commissioner not later than the 30th day after the date of notice of the failure or within any longer period specified in the notice and determined by the commissioner to be reasonable; or(9)
has or is utilizing market power in an anticompetitive manner, in accordance with established antitrust principles of market power analysis.
Source:
Section 848.201 — Enforcement Actions, https://statutes.capitol.texas.gov/Docs/IN/htm/IN.848.htm#848.201 (accessed Jun. 5, 2024).
