Texas Insurance Code - Section 38.252. Collection Of Information; Report
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§ 38.252. COLLECTION OF INFORMATION; REPORT. (a) The
commissioner shall require a health benefit plan issuer to collect
and report cost and utilization data for each mandated health
benefit and mandated offer designated by the commissioner.
(b) The commissioner shall designate by rule:
(1) the issuers of health benefit plans that must
collect and report data based on the annual dollar amounts of Texas
premium collected by the health benefit plan issuer;
(2) the specific mandated health benefits and mandated
offers of coverage for which data must be collected;
(3) a description of the data that must be collected;
(4) the beginning and ending dates of the reporting
periods, which shall be no less than every two years;
(5) the date following the end of the reporting period
by which the report shall be submitted to the commissioner;
(6) the detail and form in which the report shall be
submitted; and
(7) any other reasonable requirements that the
commissioner determines are necessary to determine the impact of
mandated benefits and mandated offers of coverage for which data
collection and reporting is required.
(c) The commissioner shall not require reporting of data:
(1) that could reasonably be used to identify a
specific enrollee in a health benefit plan;
(2) in any way that violates confidentiality
requirements of state or federal law applicable to an enrollee in a
health benefit plan; or
(3) in which the health maintenance organization
operating under the Texas Health Maintenance Organization Act
(Chapter 20A, Vernon's Texas Insurance Code) does not directly
process the claim or does not receive complete and accurate
encounter data.
Added by Acts 2001, 77th Leg., ch. 852, § 1, eff. Sept. 1, 2001.
Section: 38.202 38.203 38.204 38.205 38.206 38.207 38.251 38.252 38.253 38.254 38.301 38.302 39.001 39.002 39.003
Last modified: August 11, 2007
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