Tex. Ins. Code § 1551.229. Out-of-Network Facility-Based Provider Payments: Texas Employees Group Benefits Act – Texas

Status: Enacted
Year Enacted: 2019
File: Download

The administrator of a managed care plan provided under the group benefits program shall pay for a covered health care or medical service performed for or a covered supply related to that service provided to a participant by an out-of-network 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 participating provider.

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