Applicability of Subchapter

Sec. 4201.652. APPLICABILITY OF SUBCHAPTER. This subchapter applies only to: (1) a health benefit plan offered by a health maintenance organization operating under Chapter 843, except that this subchapter does not apply to: (A) the child health plan program under Chapter 62, Health and Safety Code, or the health benefits plan for children under Chapter 63, Health and Safety Code; or (B) the state Medicaid program, including the Medicaid managed care program operated under Chapter 540 or 540A, Government Code, as applicable; (2) a preferred provider benefit plan or exclusive provider benefit plan offered by an insurer under Chapter 1301; and (3) a person who contracts with a health maintenance organization or insurer to issue preauthorization determinations or perform the functions described in this subchapter for a health benefit plan to which this subchapter applies. Added by Acts 2021, 87th Leg., R.S., Ch. 1018 (H.B. 3459), Sec. 5, eff. September 1, 2021. Amended by: Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 2.140, eff. April 1, 2025.