Texas Statutes (Last Updated: January 4, 2014) |
INSURANCE CODE |
Title 6. ORGANIZATION OF INSURERS AND RELATED ENTITIES |
Subtitle C. LIFE, HEALTH, AND ACCIDENT INSURERS AND RELATED ENTITIES |
Chapter 843. HEALTH MAINTENANCE ORGANIZATIONS |
Subchapter I. RELATIONS WITH PHYSICIANS AND PROVIDERS |
Sec. 843.3115. CONTRACTS WITH DENTISTS
Latest version.
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(a) In this section, "covered service" means a dental care service for which reimbursement is available under an enrollee's health care plan contract, or for which reimbursement is available subject to a contractual limitation, including:
(1) a deductible;
(2) a copayment;
(3) coinsurance;
(4) a waiting period;
(5) an annual or lifetime maximum limit;
(6) a frequency limitation; or
(7) an alternative benefit payment.
(b) A contract between a health maintenance organization and a dentist may not limit the fee the dentist may charge for a service that is not a covered service.
Added by Acts 2011, 82nd Leg., R.S., Ch. 1061 , Sec. 1, eff. September 1, 2011.