Texas Insurance Code - Not Codified - Article 3.70-3D. Consumer Assistance Program For Health Maintenance Organizations
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Art. 3.70-3D. CONSUMER ASSISTANCE PROGRAM FOR HEALTH
MAINTENANCE ORGANIZATIONS.
Text of article effective upon appropriation of funds
(a) The consumer assistance program for health maintenance
organizations is established. The commissioner may contract,
through a request for proposals, with a nonprofit organization to
operate the program.
(b) The program shall:
(1) assist individual consumers in complaints or appeals
within the operation of a health maintenance organization, and
outside of the operation of a health maintenance organization,
including appeals under Article 21.58A of this code or in Medicaid
and Medicare fair hearings; and
(2) refer consumers to other programs or agencies if
appropriate.
(c) The program may:
(1) operate a statewide clearinghouse for objective
consumer information about health care coverage, including options
for obtaining health care coverage; and
(2) accept gifts, grants, or donations from any source for
the purpose of operating the program. The program may charge
reasonable fees to consumers to support the program.
(d) The commissioner or an entity contracting with the
commissioner to implement this article may establish an advisory
committee composed of consumers, health care providers, and health
care plan representatives.
(e) A nonprofit organization contracting with the
commissioner pursuant to Subsection (a) must not be involved in
providing health care or health care plans and must demonstrate
that it has expertise in providing direct assistance to consumers
with respect to their concerns and problems with health maintenance
organizations.
Added by Acts 1999, 76th Leg., ch. 1457, Sec. 5, eff. Sept. 1, 1999.
Article: 3.51 3.51-1 3.51-2 3.51-4 3.51-5 3.51-7 3.56 3.70-3D 4.01 4.11A 4.51 4.52 4.53 4.54 4.55
Last modified: August 11, 2007
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