Tex. Ins. Code § 843.304 · Subchapter I. RELATIONS WITH PHYSICIANS AND PROVIDERS
EXCLUSION OF PROVIDER BASED ON TYPE OF LICENSE PROHIBITED.
Text — Current through the 89th 2nd Called Legislative Session, 2025
(a) A provider licensed or otherwise authorized to practice in this state may not be denied the opportunity to participate in providing health care services that are delivered by a health maintenance organization and that are within the scope of the provider's license or authorization solely because of the type of license or authorization held by the provider.
(b) If a hospital, facility, agency, or supplier is certified by the Medicare program, Title XVIII of the Social Security Act (42 U.S.C. Section 1395 et seq.), or accredited by the Joint Commission on Accreditation of Healthcare Organizations or another national accrediting body, a health maintenance organization shall accept that certification or accreditation.
(c) This section does not require that a health maintenance organization:
(1) use a particular type of provider in its operation;
(2) accept each provider of a category or type, except as provided by Article 21.52B; or
(3) contract directly with providers of a particular category or type.
(d) This section does not limit a health maintenance organization's authority to establish the terms under which health care services are provided by providers.
(e) A provider must comply with the terms established by the health maintenance organization for the provision of health services and for designation as a provider by the health maintenance organization.
Notes and commentary — not statutory text
History
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.
Source of truth
- Edition
- Current through the 89th 2nd Called Legislative Session, 2025
- Official file
- https://statutes.capitol.texas.gov/Docs/IN/htm/IN.843.htm
- Text hash
- sha256 5520c5223cb4128a6900e5c984c2a3f371e8e784bdcbd4da71d31750ba25085f
- 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
Cited by 2 provisions
Provisions in this library whose text cites Tex. Ins. Code § 843.304. 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.