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Tex. Ins. Code § 843.339

DEADLINE FOR ACTION ON PRESCRIPTION CLAIMS; PAYMENT

Known as the Texas Health Maintenance Organization Act

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

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

(a) A health maintenance organization, or a pharmacy benefit manager that administers pharmacy claims for the health maintenance organization, that affirmatively adjudicates a pharmacy claim that is electronically submitted shall pay the total amount of the claim through electronic funds transfer not later than the 18th day after the date on which the claim was affirmatively adjudicated.

(b) A health maintenance organization, or a pharmacy benefit manager that administers pharmacy claims for the health maintenance organization, that affirmatively adjudicates a pharmacy claim that is not electronically submitted shall pay the total amount of the claim not later than the 21st day after the date on which the claim was affirmatively adjudicated.

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