Tex. Ins. Code § 843.316

Current with legislation from the 2023 Regular and Special Sessions signed by the Governor as of November 21, 2023.

Section 843.316 - Alternative Capitation System

As an alternative to the procedures prescribed by Section 843.315, a health maintenance organization may request approval from the department of a capitation payment system that ensures:

(1) immediate availability and accessibility of a primary care physician or primary care provider; and

(2) payment to a primary care physician or primary care provider of a capitated amount certified by a qualified actuary to be actuarially sufficient to compensate the primary care physician or primary care provider for the risk assumed.

Tex. Ins. Code § 843.316

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. 6/1/2003.