Tex. Ins. Code § 843.314. Inducement to Limit Medically Necessary Services Prohibited: Texas Health Maintenance Organization Act – Texas

Status: Enacted
Year Enacted: 2001
Year Amended: 2003
File: Download

A health maintenance organization may not use a financial incentive or make a payment to a physician or provider if the incentive or payment acts directly or indirectly as an inducement to limit medically necessary services. This section does not prohibit the use of capitation as a method of payment. See definition section Tex. Ins. Code § 843.002.

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