Texas Insurance Code 1271.201 – Designation of Specialist as Primary Care Physician
Current as of: 2024 | Check for updates
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(a) An evidence of coverage must provide that an enrollee with a chronic, disabling, or life-threatening illness may apply to the health maintenance organization’s medical director to use a nonprimary care physician specialist as the enrollee’s primary care physician.
(b) The application must:
(1) include information specified by the health maintenance organization, including certification of the medical need; and
(2) be signed by the enrollee and the nonprimary care physician specialist interested in serving as the enrollee’s primary care physician.
Terms Used In Texas Insurance Code 1271.201
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
- Signed: includes any symbol executed or adopted by a person with present intention to authenticate a writing. See Texas Government Code 311.005
(c) To be eligible to serve as the enrollee’s primary care physician, a physician specialist must:
(1) meet the health maintenance organization’s requirements for primary care physician participation; and
(2) agree to accept the responsibility to coordinate all of the enrollee’s health care needs.