Sec. 843.316. ALTERNATIVE CAPITATION SYSTEM. As an alternative to the procedures prescribed by Section 843.315, a health maintenance organization may request approval from the department of a capitation payment system that ensures:
(1) immediate availability and accessibility of a primary care physician or primary care provider; and
(2) payment to a primary care physician or primary care provider of a capitated amount certified by a qualified actuary to be actuarially sufficient to compensate the primary care physician or primary care provider for the risk assumed.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.
Section: Previous 843.310 843.311 843.3115 843.312 843.313 843.314 843.315 843.316 843.317 843.318 843.319 843.320 843.321 843.323 843.336 NextLast modified: September 28, 2016