Texas Insurance Code 1301.0058 – Protected Communications by Preferred Providers
Current as of: 2024 | Check for updates
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(a) An insurer may not in any manner prohibit, attempt to prohibit, penalize, terminate, or otherwise restrict a preferred provider from communicating with an insured about the availability of out-of-network providers for the provision of the insured’s medical or health care services.
(b) An insurer may not terminate the contract of or otherwise penalize a preferred provider solely because the provider’s patients use out-of-network providers for medical or health care services.
Terms Used In Texas Insurance Code 1301.0058
- Contract: A legal written agreement that becomes binding when signed.
(c) An insurer’s contract with a preferred provider may require that, except in a case of a medical emergency as determined by the preferred provider, before the provider may make an out-of-network referral for an insured, the preferred provider inform the insured:
(1) that:
(A) the insured may choose a preferred provider or an out-of-network provider; and
(B) if the insured chooses the out-of-network provider the insured may incur higher out-of-pocket expenses; and
(2) whether the preferred provider has a financial interest in the out-of-network provider.