(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.

Ask an insurance law question, get an answer ASAP!
Click here to chat with a lawyer about your rights.

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.