Tex. Ins. Code § 1379.051 · Subchapter B. COVERAGE FOR ROUTINE PATIENT CARE COSTS
ROUTINE PATIENT CARE COSTS.
Text — Current through the 89th 2nd Called Legislative Session, 2025
For purposes of this chapter, routine patient care costs means the costs of any medically necessary health care service for which benefits are provided under a health benefit plan, without regard to whether the enrollee is participating in a clinical trial. Routine patient care costs do not include:
(1) the cost of an investigational new drug or device that is not approved for any indication by the United States Food and Drug Administration, including a drug or device that is the subject of the clinical trial;
(2) the cost of a service that is not a health care service, regardless of whether the service is required in connection with participation in a clinical trial;
(3) the cost of a service that is clearly inconsistent with widely accepted and established standards of care for a particular diagnosis;
(4) a cost associated with managing a clinical trial; or
(5) the cost of a health care service that is specifically excluded from coverage under a health benefit plan.
Notes and commentary — not statutory text
History
Added by Acts 2009, 81st Leg., R.S., Ch. 719 (S.B. 39), Sec. 1, eff. September 1, 2009.
Source of truth
- Edition
- Current through the 89th 2nd Called Legislative Session, 2025
- Official file
- https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1379.htm
- Text hash
- sha256 27e6ecf0df7e4fb32957f8b0ed7773ec44523bab9432c440768e5559a71e5bb9
- 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.