Tex. Ins. Code § 1460.003 · Chapter 1460. STANDARDS REQUIRED REGARDING CERTAIN PHYSICIAN RANKINGS BY HEALTH BENEFIT PLANS
PHYSICIAN RANKING REQUIREMENTS.
Text — Current through the 89th 2nd Called Legislative Session, 2025
(a) A health benefit plan issuer, including a subsidiary or affiliate, may not rank physicians or classify physicians into tiers based on performance unless:
(1) the standards used by the health benefit plan issuer to rank or classify are developed or prescribed by an organization designated by the commissioner through rules adopted under Section 1460.005;
(2) the ranking or classification and any methodology used to rank or classify:
(A) is disclosed to each affected physician at least 45 days before the date the ranking or classification is released, published, or distributed by the health benefit plan issuer; and
(B) identifies which products or networks offered by the health benefit plan issuer the ranking or classification will be used for; and
(3) each affected physician is given an easy-to-use process to identify:
(A) before the release, publication, or distribution of the ranking or classification, any discrepancy between the standards and the ranking or classification proposed by the health benefit plan issuer; and
(B) after the release, publication, or distribution of the ranking or classification, any objectively and verifiably false information contained in the ranking or classification.
(a-1) If a physician submits information under Subsection (a)(3) sufficient to establish a verifiable discrepancy or objectively and verifiably false information contained in the ranking or classification or a violation of this chapter, the health benefit plan issuer must remedy the discrepancy, false information, or violation by the later of:
(1) the release, publication, or distribution of the ranking or classification; or
(2) the 30th day after the date the health benefit plan issuer receives the information.
(b) This section does not apply to the publication of a list of network physicians and providers if ratings or comparisons are not made and the list is not a product of nor reflects the tiering or classification of physicians or providers.
Notes and commentary — not statutory text
History
Added by Acts 2009, 81st Leg., R.S., Ch. 652 (H.B. 1888), Sec. 1, eff. September 1, 2009.
Amended by:
Acts 2025, 89th Leg., R.S., Ch. 787 (S.B. 926), Sec. 4, eff. September 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.1460.htm
- Text hash
- sha256 03abbd7ffa777a00bbb53e5d643035c5490410da9cbd031e79855140d1494238
- 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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