Tex. Ins. Code § 1217.002 · Chapter 1217. STANDARD REQUEST FORM FOR PRIOR AUTHORIZATION OF HEALTH CARE SERVICES
APPLICABILITY OF CHAPTER.
Text — Current through the 89th 2nd Called Legislative Session, 2025
(a) This chapter applies only to a health benefit plan that provides benefits for medical or surgical expenses incurred as a result of a health condition, accident, or sickness, including an individual, group, blanket, or franchise insurance policy or insurance agreement, a group hospital service contract, or a small or large employer group contract or similar coverage document that is offered by:
(1) an insurance company;
(2) a group hospital service corporation operating under Chapter 842;
(3) a fraternal benefit society operating under Chapter 885;
(4) a stipulated premium company operating under Chapter 884;
(5) a reciprocal exchange operating under Chapter 942;
(6) a health maintenance organization operating under Chapter 843;
(7) a multiple employer welfare arrangement that holds a certificate of authority under Chapter 846; or
(8) an approved nonprofit health corporation that holds a certificate of authority under Chapter 844.
(b) This chapter applies to group health coverage made available by a school district in accordance with Section 22.004, Education Code.
(c) Notwithstanding any provision in Chapter 1551, 1575, 1579, or 1601 or any other law, this chapter applies to:
(1) a basic coverage plan under Chapter 1551;
(2) a basic plan under Chapter 1575;
(3) a primary care coverage plan under Chapter 1579; and
(4) basic coverage under Chapter 1601.
(d) Notwithstanding any other law, this chapter applies to coverage under:
(1) the child health plan program under Chapter 62, Health and Safety Code, or the health benefits plan for children under Chapter 63, Health and Safety Code; and
(2) a Medicaid managed care program operated under Chapter 540 or 540A, Government Code, as applicable, or a Medicaid program operated under Chapter 32, Human Resources Code.
Notes and commentary — not statutory text
History
Added by Acts 2013, 83rd Leg., R.S., Ch. 1198 (S.B. 1216), Sec. 1, eff. September 1, 2013.
Amended by:
Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 2.120, eff. April 1, 2025.
Source of truth
- Edition
- Current through the 89th 2nd Called Legislative Session, 2025
- Official file
- https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1217.htm
- Text hash
- sha256 2a98caa176f85ce1527a506ab52cb44d5e2ff785fc77e250b5f5181bbaa0f228
- 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
This section cites
Provisions in this library that the text above cites, as it prints each citation. A range cited as “ss. 61.13-61.16” links its first and last provisions.
Education Code
Health and Safety Code
Human Resources Code
Insurance Code
- Tex. Ins. Code ch. 842GROUP HOSPITAL SERVICE CORPORATIONSPrinted as Chapter 842
- Tex. Ins. Code ch. 843HEALTH MAINTENANCE ORGANIZATIONSPrinted as Chapter 843
- Tex. Ins. Code ch. 846MULTIPLE EMPLOYER WELFARE ARRANGEMENTSPrinted as Chapter 846
- Tex. Ins. Code ch. 884STIPULATED PREMIUM INSURANCE COMPANIESPrinted as Chapter 884
- Tex. Ins. Code ch. 885FRATERNAL BENEFIT SOCIETIESPrinted as Chapter 885
- Tex. Ins. Code ch. 942RECIPROCAL AND INTERINSURANCE EXCHANGESPrinted as Chapter 942
- Tex. Ins. Code ch. 1551TEXAS EMPLOYEES GROUP BENEFITS ACTPrinted as Chapter 1551
- Tex. Ins. Code ch. 1575TEXAS PUBLIC SCHOOL EMPLOYEES GROUP BENEFITS PROGRAMPrinted as Chapter 1575
- Tex. Ins. Code ch. 1579TEXAS SCHOOL EMPLOYEES UNIFORM GROUP HEALTH COVERAGEPrinted as Chapter 1579
Cited by 2 provisions
Provisions in this library whose text cites Tex. Ins. Code § 1217.002. Each shows the citation as that text prints it.
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.