Texas Administrative Code
Title 28 - INSURANCE
Part 1 - TEXAS DEPARTMENT OF INSURANCE
Chapter 21 - TRADE PRACTICES
Subchapter T - SUBMISSION OF CLEAN CLAIMS
Section 21.2822 - Administrative Penalties

Universal Citation: 28 TX Admin Code § 21.2822

Current through Reg. 50, No. 13; March 28, 2025

(a) An MCC that fails to comply with § 21.2807 of this title (relating to Effect of Filing a Clean Claim) for more than 2 percent of clean claims submitted to the MCC is subject to an administrative penalty under Insurance Code § 843.342(k) or § 1301.137(k), as applicable.

(b) The percentage of the MCC's compliance with § 21.2807 of this title must be determined on a quarterly basis and must be separated into a compliance percentage for noninstitutional preferred provider claims and institutional preferred provider claims. Claims paid in compliance with § 21.2809 of this title (relating to Audit Procedures) are not included in calculating the compliance percentage under this section.

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