Tex. Ins. Code § 1662.105 · Subchapter C. REQUIRED PUBLIC DISCLOSURES
OUT-OF-NETWORK ALLOWED AMOUNTS.
Text — Current through the 89th 2nd Called Legislative Session, 2025
(a) An out-of-network allowed amount provided under Section 1662.103(a)(2)(C) must be:
(1) reflected as a dollar amount with respect to each covered health care service or supply that is provided by an out-of-network provider; and
(2) associated with the national provider identifier, tax identification number, and place of service code for each out-of-network provider.
(b) This subchapter does not prohibit a health benefit plan issuer or administrator from satisfying the disclosure requirements described by Section 1662.103(a)(2)(C) by disclosing out-of-network allowed amounts made available by, or otherwise obtained from, an issuer, a health care provider, or other party with which the issuer or administrator has entered into a written agreement to provide the information if the minimum claim threshold described by Section 1662.103(b) is independently met for each health care service or supply and for each plan included in an aggregated allowed amount file.
(c) If a health benefit plan issuer or administrator enters into an agreement under Subsection (b), the health benefit plan issuers, health care providers, or other persons with which the issuer or administrator has contracted may aggregate out-of-network allowed amounts for more than one plan.
(d) This subchapter does not prohibit a third party from hosting an allowed amount file on its Internet website or a health benefit plan issuer or administrator from contracting with a third party to post the file. If the issuer or administrator does not host the file separately on its Internet website, the issuer or administrator shall provide a link on its Internet website to the location where the file is made publicly available.
Notes and commentary — not statutory text
History
Added by Acts 2021, 87th Leg., R.S., Ch. 333 (H.B. 2090), Sec. 3, eff. September 1, 2021.
Source of truth
- Edition
- Current through the 89th 2nd Called Legislative Session, 2025
- Official file
- https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1662.htm
- Text hash
- sha256 0270de157dc6917b7d2df92d58456f2d37410c630e2780ba98fac079ed6dbaa0
- 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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