Tex. Ins. Code § 1366.057 · Subchapter B. MINIMUM INPATIENT STAY FOLLOWING BIRTH OF CHILD AND POSTDELIVERY CARE
PROHIBITED CONDUCT.
Text — Current through the 89th 2nd Called Legislative Session, 2025
An issuer of a health benefit plan may not:
(1) modify the terms and conditions of coverage based on a request by an enrollee for less than the minimum coverage required under Section 1366.055(a);
(2) offer to a woman who has given birth to a child a financial incentive or other compensation the receipt of which is contingent on the waiver by the woman of the minimum coverage required under Section 1366.055(a);
(3) refuse to accept a physician's recommendation for inpatient care made in consultation with the woman who has given birth to a child if the period of inpatient care recommended by the physician does not exceed the minimum periods recommended in guidelines for perinatal care developed by:
(A) the American College of Obstetricians and Gynecologists;
(B) the American Academy of Pediatrics; or
(C) another nationally recognized professional association of obstetricians and gynecologists or of pediatricians;
(4) reduce payments or other forms of reimbursement for inpatient care below the usual and customary rate of reimbursement for that care; or
(5) penalize a physician for recommending inpatient care for a woman or the woman's newborn child by:
(A) refusing to permit the physician to participate as a provider in the health benefit plan;
(B) reducing payments made to the physician;
(C) requiring the physician to:
(i) provide additional documentation; or
(ii) undergo additional utilization review; or
(D) imposing other analogous sanctions or disincentives.
Notes and commentary — not statutory text
History
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 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.1366.htm
- Text hash
- sha256 2deeb669650b7748ed10c43c2ceb04a89d5c8dd520e5cf4e5951ed8a93c09256
- 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
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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.