Tex. Ins. Code § 38.252 · Subchapter F. DATA COLLECTING AND REPORTING RELATING TO MANDATED HEALTH BENEFITS AND MANDATED OFFERS OF COVERAGE
COLLECTION OF INFORMATION; REPORT.
Text — Current through the 89th 2nd Called Legislative Session, 2025
(a) The commissioner shall require a health benefit plan issuer to collect and report cost and utilization data for each mandated health benefit and mandated offer designated by the commissioner.
(b) The commissioner shall designate by rule:
(1) the issuers of health benefit plans that must collect and report data based on the annual dollar amounts of Texas premium collected by the health benefit plan issuer;
(2) the specific mandated health benefits and mandated offers of coverage for which data must be collected;
(3) a description of the data that must be collected;
(4) the beginning and ending dates of the reporting periods, which shall be no less than every two years;
(5) the date following the end of the reporting period by which the report shall be submitted to the commissioner;
(6) the detail and form in which the report shall be submitted; and
(7) any other reasonable requirements that the commissioner determines are necessary to determine the impact of mandated benefits and mandated offers of coverage for which data collection and reporting is required.
(c) The commissioner shall not require reporting of data:
(1) that could reasonably be used to identify a specific enrollee in a health benefit plan;
(2) in any way that violates confidentiality requirements of state or federal law applicable to an enrollee in a health benefit plan; or
(3) in which the health maintenance organization operating under Section 1367.053, Subchapter A, Chapter 1452, Subchapter B, Chapter 1507, Chapter 222, 251, or 258, as applicable to a health maintenance organization, Chapter 843, Chapter 1271, and Chapter 1272 does not directly process the claim or does not receive complete and accurate encounter data.
Notes and commentary — not statutory text
History
Added by Acts 2001, 77th Leg., ch. 852, Sec. 1, eff. Sept. 1, 2001.
Amended by:
Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 2B.009, eff. April 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.38.htm
- Text hash
- sha256 da6fd0a6afa67c19d4fd4e1f4ce02f2990af1cd52e5e7dac51d2215adb790b4e
- 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.
Insurance Code
- Tex. Ins. Code ch. 222LIFE, HEALTH, AND ACCIDENT INSURANCE PREMIUM TAXPrinted as Chapter 222
- Tex. Ins. Code ch. 843HEALTH MAINTENANCE ORGANIZATIONSPrinted as Chapter 843
- Tex. Ins. Code ch. 1271BENEFITS PROVIDED BY HEALTH MAINTENANCE ORGANIZATIONS; EVIDENCE OF COVERAGE; CHARGESPrinted as Chapter 1271
- Tex. Ins. Code ch. 1272DELEGATION OF CERTAIN FUNCTIONS BY HEALTH MAINTENANCE ORGANIZATIONPrinted as Chapter 1272
- Tex. Ins. Code § 1367.053COVERAGE REQUIRED.Printed as Section 1367.053
- Tex. Ins. Code ch. 1452, subch. ACREDENTIALING OF PHYSICIANS AND PROVIDERS BY HEALTH MAINTENANCE ORGANIZATIONPrinted as Subchapter A, Chapter 1452
- Tex. Ins. Code ch. 1507, subch. BCONSUMER CHOICE OF BENEFITS HEALTH MAINTENANCE ORGANIZATION PLANSPrinted as Subchapter B, Chapter 1507
Cited by 1 provision
Provisions in this library whose text cites Tex. Ins. Code § 38.252. Each shows the citation as that text prints it.
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.