Code: 

Insurance Code

Title: 

Title 14. Utilization Review and Independent Review

Section: 

4201.652

Name: 

Applicability of Subchapter

Eff. Date: 

September 1, 2021

No Rule Reference

§4201.652
Applicability of Subchapter

<Text of section effective until April 1, 2025. See, also, § 4201.652 effective April 1, 2025.>

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.

Added by Acts 2021, 87th Leg., ch. 1018 (H.B. 3459), § 5, eff. Sept. 1, 2021.