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Tex. Ins. Code § 843.316

ALTERNATIVE CAPITATION SYSTEM

Known as the Texas Health Maintenance Organization Act

The act spans §§ 843.001–843.464 (146 sections).

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

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.

Official source: Texas Constitution and Statutes. Reproduced from public-domain Texas statutes; confirm against the official source for the current text. Not legal advice.