Section 1357.005 - Prohibited Conduct(a) An issuer of a health benefit plan may not:(1) offer a financial incentive for an enrollee to not receive breast reconstruction or to waive the coverage required under this subchapter;(2) condition, limit, or deny the eligibility of a person to enroll in the plan or to renew coverage under the terms of the plan solely to avoid the requirements of this subchapter; or(3) reduce or limit the reimbursement or amount paid to, or otherwise penalize, an attending physician or provider or provide a financial incentive or other benefit to an attending physician or provider to induce the physician or provider to provide care to an enrollee in a manner that is inconsistent with this subchapter.(b) This section does not prevent an issuer of a health benefit plan from negotiating with a physician or provider the level and type of reimbursement that the physician or provider will receive for care provided in accordance with this subchapter.Tex. Ins. Code § 1357.005
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. 4/1/2005.