Texas Administrative Code
Title 28 - INSURANCE
Part 1 - TEXAS DEPARTMENT OF INSURANCE
Chapter 11 - HEALTH MAINTENANCE ORGANIZATIONS
Subchapter Q - OTHER REQUIREMENTS
Section 11.1603 - Notification of Change in Payment Arrangements
Universal Citation: 28 TX Admin Code § 11.1603
Current through Reg. 50, No. 13; March 28, 2025
An HMO must provide written notification to affected group contract holders of a substantive change in the payment arrangement for physicians and providers within 30 days of any change in the type of payment arrangement; for example, a change from capitation to fee for service, or from fee for service to capitation, for any type of service. The notification of the change must include a description of the changed payment arrangement and a description of the new payment arrangement.
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