tx-May82026-47: 28 TAC §21.3202 (New) — Trade Practices
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STATUTORY AUTHORITY. TDI proposes new §21.3202 under Insurance Code §§1460.003(a), 1460.005(a) and (b) and 36.001. Insurance Code §1460.003(a) prohibits health benefit plan issuers from ranking or classifying physicians into tiers based on performance unless, among other things, the standards used to rank or classify are developed or prescribed by an organization designated by the commissioner by rule. Insurance Code §1460.005(a) requires the commissioner to adopt rules as necessary to implement Insurance Code Chapter 1460. Insurance Code §1460.005(b) requires the commissioner to adopt rules as necessary to ensure that a health benefit plan issuer that uses a physician ranking system complies with the standards and guidelines described in Insurance Code §1460.005(c). Insurance Code §36.001 provides that the commissioner may adopt any rules necessary and appropriate to implement the powers and duties of TDI under the Insurance Code and other laws of this state. CROSS-REFERENCE TO STATUTE. New §21.3202 implements Insurance Code Chapter 1460. §21.3202. Designated Organizations for Physician Ranking. (a) For the purposes of Insurance Code Chapter 1460, concerning Standards Required...
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