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Texas Statutes (Last Updated: January 4, 2014) |
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INSURANCE CODE |
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Title 6. ORGANIZATION OF INSURERS AND RELATED ENTITIES |
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Subtitle C. LIFE, HEALTH, AND ACCIDENT INSURERS AND RELATED ENTITIES |
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Chapter 843. HEALTH MAINTENANCE ORGANIZATIONS |
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Subchapter H. GENERAL PROVISIONS REGARDING COMPLAINTS |
Sec. 843.281. RETALIATORY ACTION PROHIBITED
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(a) A health maintenance organization may not engage in retaliatory action, including refusal to renew or cancellation of coverage, against a group contract holder or enrollee because the group or enrollee or a person acting on behalf of the group or enrollee has filed a complaint against the health maintenance organization or appealed a decision of the health maintenance organization.
(b) A health maintenance organization may not engage in retaliatory action, including refusal to renew or termination of a contract, against a physician or provider because the physician or provider has, on behalf of an enrollee, reasonably filed a complaint against the health maintenance organization or appealed a decision of the health maintenance organization.