Texas Insurance Code 1305.006 – Insurance Carrier Liability for Out-of-Network Health Care
Current as of: 2024 | Check for updates
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Terms Used In Texas Insurance Code 1305.006
- Contract: A legal written agreement that becomes binding when signed.
An insurance carrier that establishes or contracts with a network is liable for the following out-of-network health care that is provided to an injured employee:
(1) emergency care;
(2) health care provided to an injured employee who does not live within the service area of any network established by the insurance carrier or with which the insurance carrier has a contract; and
(3) health care provided by an out-of-network provider pursuant to a referral from the injured employee’s treating doctor that has been approved by the network pursuant to § 1305.103.