Tex. Codes » Insurance Code · TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES · SUBTITLE F. PHYSICIANS AND HEALTH CARE PROVIDERS · CHAPTER 1467. OUT-OF-NETWORK CLAIM DISPUTE RESOLUTION
Texas Codes

Tex. Ins. Code § 1467.089 (2026)

Effect Of Decision

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

Sec. 1467.089. EFFECT OF DECISION. (a) An arbitrator's decision under Section 1467.088 is binding.

(b) Not later than the 45th day after the date of an arbitrator's decision under Section 1467.088, a party not satisfied with the decision may file an action to determine the payment due to an out-of-network provider.

(c) In an action filed under Subsection (b), the court shall determine whether the arbitrator's decision is proper based on a substantial evidence standard of review.

(d) Not later than the 30th day after the date of an arbitrator's decision under Section 1467.088, a health benefit plan issuer or administrator shall pay to an out-of-network provider any additional amount necessary to satisfy the binding award.

Added by Acts 2019, 86th Leg., R.S., Ch. 1342 (S.B. 1264), Sec. 2.15, eff. September 1, 2019.

SUBCHAPTER C. BAD FAITH PARTICIPATION


Notes of Decisions
Cited in 2 cases (2 in the last 5 years), 2023–2023 · leading case: Michael Nazarian MD Assoc. LLC v. Aetna Life Ins. Co., Inc. (Tex. App. 2023).
Sort: Relevance Newest Treatment
Unitedhealthcare Ins. Co. Unitedhealthcare of Texas, Inc. v. Acs Primary Care Physicians Sw., P.A. Hill Cnty. Emergency Med. Assocs., P.A. Longhorn Emergency Med. Assocs., P.A. Cent. Texas Emergency Assocs., P.A. Emergency Assocs. of Cent. Texas, P.A. Emergency Servs. of Texas, P.A. (Tex. 2023). “Quantum 82 TEX. INS. CODE § 1467.089(a). 83 Id. § 1467.”
Michael Nazarian MD Assoc. LLC v. Aetna Life Ins. Co., Inc. (Tex. App. 2023). “2 See Tex. Ins. Code Ann. §§ 1467.089 (a), .084(a).”
— Tex. Ins. Code § 1467.089(a) — 1 case
Unitedhealthcare Ins. Co. Unitedhealthcare of Texas, Inc. v. Acs Primary Care Physicians Sw., P.A. Hill Cnty. Emergency Med. Assocs., P.A. Longhorn Emergency Med. Assocs., P.A. Cent. Texas Emergency Assocs., P.A. Emergency Assocs. of Cent. Texas, P.A. Emergency Servs. of Texas, P.A. (Tex. 2023). “Quantum 82 TEX. INS. CODE § 1467.089(a). 83 Id. § 1467.”
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.