Tex. Ins. Code § 1451.256 · Subchapter F. ACCESS TO OBSTETRICAL OR GYNECOLOGICAL CARE
DIRECT ACCESS TO SERVICES OF OBSTETRICIAN OR GYNECOLOGIST.
Text — Current through the 89th 2nd Called Legislative Session, 2025
(a) In this section, "health care services" includes:
(1) one well-woman examination each year;
(2) care related to pregnancy;
(3) care for any active gynecological condition; and
(4) diagnosis, treatment, and referral for any disease or condition that is within the scope of the professional specialty practice of a properly credentialed obstetrician or gynecologist.
(b) In addition to other benefits authorized under the health benefit plan, a health benefit plan shall permit an enrollee who selects an obstetrician or gynecologist under Section 1451.255 to have direct access to the health care services of that selected physician without:
(1) a referral from the enrollee's primary care physician; or
(2) prior authorization or precertification from the plan issuer.
(c) A health benefit plan may not impose a copayment or deductible for direct access to health care services as required by this section unless the same copayment or deductible is imposed for access to other health care services provided under the plan.
(d) This section does not affect the authority of a health benefit plan issuer to require an obstetrician or gynecologist selected by an enrollee under Section 1451.255 to forward information concerning the medical care of the enrollee to the enrollee's primary care physician.
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.1451.htm
- Text hash
- sha256 c918244a340371619caaf5d4f2a11d466ee787de66aef7f438bc3540490a0262
- 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.
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.