Tex. Codes » Insurance Code · TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES · SUBTITLE D. PROVIDER PLANS · CHAPTER 1301. PREFERRED PROVIDER BENEFIT PLANS
Texas Codes

Tex. Ins. Code § 1301.069 (2026)

Services Provided By Certain Physicians And Health Care Providers

✓ current as of May 2026
Find cases: SyfertCases citing this section TX-LEGstatutes.capitol.texas.gov Justiaon Justia CornellLII Search CasesGoogle Scholar

Sec. 1301.069. SERVICES PROVIDED BY CERTAIN PHYSICIANS AND HEALTH CARE PROVIDERS. The provisions of this chapter relating to prompt payment by an insurer of a physician or health care provider and to verification of medical care or health care services apply to a physician or provider who:

(1) is not a preferred provider included in the preferred provider network; and

(2) provides to an insured:

(A) care related to an emergency or its attendant episode of care as required by state or federal law; or

(B) specialty or other medical care or health care services at the request of the insurer or a preferred provider because the services are not reasonably available from a preferred provider who is included in the preferred delivery network.

Added by Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.037(d), eff. September 1, 2005.

SUBCHAPTER C. PROMPT PAYMENT OF CLAIMS


Notes of Decisions
Cited in 2 cases, 2012–2014 · leading case: Emergency Health Centre at Willowbrook, L.L.C. v. Unitedhealthcare of Texas, Inc., 892 F. Supp. 2d 847 (S.D. Tex. 2012).
Sort: Relevance Newest Treatment
Emergency Health Centre at Willowbrook, L.L.C. v. Unitedhealthcare of Texas, Inc., 892 F. Supp. 2d 847 (S.D. Tex. 2012). · cites it 3× “Tex. Ins.Code § 1301.069. Because it is undisputed that EHC and the physicians in the PA were not preferred providers, EHC and PA can recover under § 1301.”
Emerus Hosp. Partners, LLC v. Health Care Serv. Corp., 41 F. Supp. 3d 695 (N.D. Ill. 2014). “Consequently, Emerus claims that this court lacks subject matter jurisdiction because any standing under ERISA, derivative or otherwise, has been waived.”
Annotations are extracted automatically from the opinions in the Syfert caselaw corpus and ranked by authority, recency, and treatment. Dots show Syfertize treatment of the citing case itself.