Texas Insurance Code 1305.101 – Providing or Arranging for Health Care
Current as of: 2024 | Check for updates
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(a) Except for emergencies and out-of-network referrals, a network shall provide or arrange for health care services only through providers or provider groups that are under contract with or are employed by the network.
(b) A network doctor may not serve as a designated doctor or perform a required medical examination, as those terms are used under the Texas Workers’ Compensation Act, for an employee receiving medical care through a network with which the doctor contracts or is employed.
Terms Used In Texas Insurance Code 1305.101
- Contract: A legal written agreement that becomes binding when signed.
(c) Notwithstanding any other provision of this chapter, prescription medication or services, as defined by § 401.011(19)(E), Labor Code, may not, directly or through a contract, be delivered through a workers’ compensation health care network. Prescription medication and services shall be reimbursed as provided by § 408.0281, Labor Code, other provisions of the Texas Workers’ Compensation Act, and applicable rules of the commissioner of workers’ compensation.
