Tex. Ins. Code § 1213.003 · Chapter 1213. ELECTRONIC HEALTH CARE TRANSACTIONS
ELECTRONIC SUBMISSION OF CLAIMS: WAIVER.
Text — Current through the 89th 2nd Called Legislative Session, 2025
(a) A contract between the issuer of a health benefit plan and a health care professional or health care facility must provide for a waiver of any requirement for electronic submission established under this chapter.
(b) The commissioner shall establish circumstances under which a waiver is required, including:
(1) circumstances in which no method is available for the submission of claims in electronic form;
(2) the operation of small physician practices;
(3) the operation of other small health care provider practices;
(4) undue hardship, including fiscal or operational hardship; or
(5) any other special circumstance that would justify a waiver.
(c) Any health care professional or health care facility that is denied a waiver by the issuer of a health benefit plan may appeal the denial to the commissioner. The commissioner shall determine whether a waiver must be granted.
(d) The issuer of a health benefit plan may not refuse to contract or renew a contract with a health care professional or health care facility based in whole or in part on the professional or facility requesting or receiving a waiver or appealing a waiver determination.
Notes and commentary — not statutory text
History
Added by Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.029(a), eff. September 1, 2005.
Source of truth
- Edition
- Current through the 89th 2nd Called Legislative Session, 2025
- Official file
- https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1213.htm
- Text hash
- sha256 c750875215f88767281802917f419268ffff57c75e2241088745a3f04f39748a
- Composed by
- compose_tx.py 2026-10-05: the Legislative Council's chapter files read in document order; verify_tx.py's independent reading (lxml DOM walk) agrees character for character
Procedural information only. Not legal advice and not a substitute for the advice of an attorney. Confirm the current text with the official publisher before relying on it.