Terms Used In Texas Insurance Code 4201.652

  • Person: includes corporation, organization, government or governmental subdivision or agency, business trust, estate, trust, partnership, association, and any other legal entity. See Texas Government Code 311.005

This subchapter applies only to:
(1) a health benefit plan offered by a health maintenance organization operating under Chapter 843, except that this subchapter does not apply to:
(A) the child health plan program under Chapter 62, Health and Safety Code, or the health benefits plan for children under Chapter 63, Health and Safety Code; or
(B) the state Medicaid program, including the Medicaid managed care program operated under Chapter 533, Government Code;
(2) a preferred provider benefit plan or exclusive provider benefit plan offered by an insurer under Chapter 1301; and
(3) a person who contracts with a health maintenance organization or insurer to issue preauthorization determinations or perform the functions described in this subchapter for a health benefit plan to which this subchapter applies.


Text of section effective until April 01, 2025