Tex. Labor Code Section 413.0115
Requirements for Certain Voluntary or Informal Networks


(a)

In this section:

(1)

“Informal network” means a health care provider network described by Section 413.011 (Reimbursement Policies and Guidelines; Treatment Guidelines and Protocols)(d-1) that:

(A)

is established under a contract between an insurance carrier and health care providers; and

(B)

includes a specific fee schedule.

(2)

“Voluntary network” means a voluntary workers’ compensation health care delivery network established by an insurance carrier under former Section 408.0223, as that section existed before repeal by Chapter 265, Acts of the 79th Legislature, Regular Session, 2005.

(b)

Not later than January 1, 2011, each informal network or voluntary network must be certified as a workers’ compensation health care network under Chapter 1305 (Workers’ Compensation Health Care Networks), Insurance Code.

(c)

Effective September 1, 2007, each informal network and voluntary network must provide the following information to the division:

(1)

an executive contact for official correspondence for the network;

(2)

a toll-free telephone number by which a health care provider may contact the informal network or voluntary network;

(3)

a list of each insurance carrier with whom the network contracts; and

(4)

a list of each entity associated with the network working on behalf of the insurance carrier, including contact information for each entity.

(d)

Each informal network and voluntary network shall report any changes to the information provided under Subsection (c) to the division not later than the 30th day after the effective date of the change.
Added by Acts 2007, 80th Leg., R.S., Ch. 1177 (H.B. 473), Sec. 3, eff. September 1, 2007.

Source: Section 413.0115 — Requirements for Certain Voluntary or Informal Networks, https://statutes.­capitol.­texas.­gov/Docs/LA/htm/LA.­413.­htm#413.­0115 (accessed Apr. 29, 2024).

413.002
Medical Review
413.003
Authority to Contract
413.004
Coordination with Providers
413.006
Advisory Committees
413.007
Information Maintained by Division
413.008
Information from Insurance Carriers
413.011
Reimbursement Policies and Guidelines
413.012
Medical Policy and Guideline Updates Required
413.013
Programs
413.014
Preauthorization Requirements
413.015
Payment by Insurance Carriers
413.016
Payments in Violation of Medical Policies and Fee Guidelines
413.017
Presumption of Reasonableness
413.018
Review of Medical Care if Guidelines Exceeded
413.019
Interest Earned for Delayed Payment, Refund, or Overpayment
413.020
Division Charges
413.021
Return-to-work Coordination Services
413.022
Return-to-work Reimbursement Program for Employers
413.023
Information to Employers
413.024
Information to Employees
413.025
Return-to-work Goals and Assistance
413.031
Medical Dispute Resolution
413.032
Independent Review Organization Decision
413.041
Disclosure
413.042
Private Claims
413.043
Overcharging Prohibited
413.044
Sanctions on Designated Doctor
413.051
Contracts with Review Organizations and Health Care Providers
413.052
Production of Documents
413.053
Standards of Reporting and Billing
413.054
Immunity from Liability
413.055
Interlocutory Orders
413.0111
Processing Agents
413.0112
Reimbursement of Federal Military Treatment Facility
413.0115
Requirements for Certain Voluntary or Informal Networks
413.0141
Initial Pharmaceutical Coverage
413.0311
Review of Medical Necessity Disputes
413.0312
Review of Medical Fee Disputes
413.0511
Medical Advisor
413.0512
Medical Quality Review Panel
413.0513
Confidentiality Requirements
413.0514
Information Sharing with Occupational Licensing Boards
413.0515
Reports of Chiropractor Violations
413.05115
Medical Quality Review Process
413.05121
Quality Assurance Panel
413.05122
Medical Quality Review Panel: Rules

Accessed:
Apr. 29, 2024

§ 413.0115’s source at texas​.gov