Tex. Ins. Code § 1272.301. Access to Out of Network Services: Delegation of Certain Functions by Health Maintenance Organization – Texas

Status: Enacted
Year Enacted: 2003
Year Amended: 2007
File: Download

A contract between an HMO and a limited provider network or delegated entity must provide a referral for medically necessary services that are out of network and fully reimburse the non-network physician at the usual and customary rate.

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