Tex. Ins. Code § 1271.157. Non-Network Facility-Based Providers: Benefits Provided By Health Maintenance Organizations; Evidence of Coverage; Charges – Texas

Status: Enacted
Year Enacted: 2019
File: Download

A health maintenance organization shall pay for a covered health care service performed for or a covered supply related to that service provided to an enrollee by a non-network physician or provider who is a facility-based provider at the usual and customary rate or at an agreed rate if the provider performed the service at a health care facility that is a network provider.

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