Section 21.5001 - PurposeThe purpose of this subchapter is to:
(1) prescribe the process for requesting, initiating, and conducting mandatory mediation and mandatory binding arbitration of claims as authorized in Insurance Code Chapter 1467, concerning Out-of-Network Claim Dispute Resolution;(2) facilitate the process for the investigation and review of a complaint filed with the department that relates to the settlement of an out-of-network claim under Insurance Code Chapter 1467;(3) prescribe the contents of the explanation of benefits as required by Insurance Code § 1271.008, concerning Balance Billing Prohibition Notice; §1275.003, concerning Balance Billing Prohibition Notice; §1301.010, concerning Balance Billing Prohibition Notice; §1551.015, concerning Balance Billing Prohibition Notice; §1575.009, concerning Balance Billing Prohibition Notice; and §1579.009, concerning Balance Billing Prohibition Notice; and(4) facilitate the collection of data as authorized in Insurance Code § 1467.006, concerning Benchmarking Database.28 Tex. Admin. Code § 21.5001
The provisions of this §21.5001 adopted to be effective October 19, 2010, 35 TexReg 9300; Amended by Texas Register, Volume 41, Number 44, October 28, 2016, TexReg 8615, eff. 11/3/2016; Amended by Texas Register, Volume 43, Number 16, April 20, 2018, TexReg 2427, eff. 4/26/2018; Amended by Texas Register, Volume 44, Number 51, December 20, 2019, TexReg 8014, eff. 12/23/2019; Amended by Texas Register, Volume 48, Number 25, June 23, 2023, TexReg 3412, eff. 6/27/2023