Tex. Ins. Code § 1301.104 · Subchapter C. PROMPT PAYMENT OF CLAIMS
DEADLINE FOR ACTION ON PHARMACY CLAIMS; PAYMENT.
Text — Current through the 89th 2nd Called Legislative Session, 2025
(a) An insurer, or a pharmacy benefit manager that administers pharmacy claims for the insurer under a preferred provider benefit plan, that affirmatively adjudicates a pharmacy claim that is electronically submitted shall pay the total amount of the claim through electronic funds transfer not later than the 18th day after the date on which the claim was affirmatively adjudicated.
(b) An insurer, or a pharmacy benefit manager that administers pharmacy claims for the insurer under a preferred provider benefit plan, that affirmatively adjudicates a pharmacy claim that is not electronically submitted shall pay the total amount of the claim not later than the 21st day after the date on which the claim was affirmatively adjudicated.
Notes and commentary — not statutory text
History
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.
Amended by:
Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.037(a), eff. September 1, 2005.
Acts 2011, 82nd Leg., R.S., Ch. 798 (H.B. 2292), Sec. 9, eff. September 1, 2011.
Source of truth
- Edition
- Current through the 89th 2nd Called Legislative Session, 2025
- Official file
- https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1301.htm
- Text hash
- sha256 dd88a394242cb2f213b5377ff4b1631c99127ac020a29f613adf6a9492c7288c
- 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
Cited by 5 provisions
Provisions in this library whose text cites Tex. Ins. Code § 1301.104. Each shows the citation as that text prints it.
Insurance Code
- Tex. Ins. Code § 1301.103DEADLINE FOR ACTION ON CLEAN CLAIMS.Printed as Sections 1301.104 and 1301.1054
- Tex. Ins. Code § 1301.1053DEADLINES NOT EXTENDED.Printed as Section 1301.103 or 1301.104
- Tex. Ins. Code § 1301.1054REQUESTS FOR ADDITIONAL INFORMATION.Printed as Section 1301.103 or 1301.104
- Tex. Ins. Code § 1301.134COORDINATION OF PAYMENT.Printed as Section 1301.103 or 1301.104
- Tex. Ins. Code § 1301.137VIOLATION OF CLAIMS PAYMENT REQUIREMENTS; PENALTY.Printed as Section 1301.103, 1301.104, or 1301.105
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.