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Tex. Lab. Code § 413.015

PAYMENT BY INSURANCE CARRIERS; AUDIT AND REVIEW

Known as the Texas Workers' Compensation Act

The act spans §§ 401–419 (623 sections).

Applied in 2 court decisions — leading case Patient Advocates v. Texas Workers Compensation Commission (2002)

Most recently applied in APOLLO ENTERPRISES, INC. v. ScripNet, Inc. (December 2009)

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff

(a) Insurance carriers shall make appropriate payment of charges for medical services provided under this subtitle. An insurance carrier may contract with a separate entity to forward payments for medical services. Any payment due the insurance carrier from the separate entity must be made in accordance with the contract. The separate entity is subject to the direction of the insurance carrier, and the insurance carrier is responsible for the actions of the separate entity under this subsection.

(b) The commissioner shall provide by rule for the review and audit of the payment by insurance carriers of charges for medical services provided under this subtitle to ensure compliance of health care providers and insurance carriers with the medical policies and fee guidelines adopted by the commissioner.

(c) The rules must require the insurance carrier to pay the expenses of the review and audit.

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