Texas Insurance Code 843.316 – Alternative Capitation System
Current as of: 2024 | Check for updates
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As an alternative to the procedures prescribed by § 843.315, a health maintenance organization may request approval from the department of a capitation payment system that ensures:
(1) immediate availability and accessibility of a primary care physician or primary care provider; and
(2) payment to a primary care physician or primary care provider of a capitated amount certified by a qualified actuary to be actuarially sufficient to compensate the primary care physician or primary care provider for the risk assumed.
