State Codes and Statutes

Statutes > Texas > Insurance-code > Title-8-health-insurance-and-other-health-coverages > Chapter-1661-information-technology

INSURANCE CODE

TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES

SUBTITLE J. HEALTH INFORMATION TECHNOLOGY

CHAPTER 1661. INFORMATION TECHNOLOGY

Sec. 1661.001. DEFINITIONS. In this chapter:

(1) "Health benefit plan" means a plan that provides benefits

for medical or surgical expenses incurred as a result of a health

condition, accident, or sickness, including an individual, group,

blanket, or franchise insurance policy or insurance agreement, a

group hospital service contract, or an individual or group

evidence of coverage that is offered by:

(A) an insurance company;

(B) a group hospital service corporation operating under Chapter

842;

(C) a fraternal benefit society operating under Chapter 885;

(D) a stipulated premium company operating under Chapter 884;

(E) a Lloyd's plan operating under Chapter 941;

(F) an exchange operating under Chapter 942;

(G) a health maintenance organization operating under Chapter

843;

(H) a multiple employer welfare arrangement that holds a

certificate of authority under Chapter 846;

(I) an approved nonprofit health corporation that holds a

certificate of authority under Chapter 844; or

(J) an entity not authorized under this code or another

insurance law of this state that contracts directly for health

care services on a risk-sharing basis, including a capitation

basis.

(2) "Health benefit plan issuer" means an entity authorized to

issue a health benefit plan in this state.

(3) "Health care provider" means:

(A) an individual who is licensed, certified, or otherwise

authorized to provide health care services; or

(B) a hospital, emergency clinic, outpatient clinic, or other

facility providing health care services.

(4) "Participating provider" means a health care provider who

has contracted with a health benefit plan issuer to provide

services to enrollees.

Added by Acts 2009, 81st Leg., R.S., Ch.

261, Sec. 1, eff. May 30, 2009.

Sec. 1661.002. USE OF CERTAIN INFORMATION TECHNOLOGY REQUIRED.

(a) A health benefit plan issuer shall use information

technology that provides a participating provider with real-time

information at the point of care concerning:

(1) the enrollee's:

(A) copayment and coinsurance;

(B) applicable deductibles; and

(C) covered benefits and services; and

(2) the enrollee's estimated total financial responsibility for

the care.

(b) A health benefit plan issuer shall use information

technology that provides an enrollee with information concerning

the enrollee's:

(1) copayment and coinsurance;

(2) applicable deductibles;

(3) covered benefits and services; and

(4) estimated financial responsibility for the health care

provided to the enrollee.

(c) Nothing in this section may be interpreted as a guarantee of

payment for health care services.

(d) A health benefit plan issuer's Internet website may be used

to meet the information technology requirements of this chapter.

Added by Acts 2009, 81st Leg., R.S., Ch.

261, Sec. 1, eff. May 30, 2009.

Sec. 1661.003. EXCEPTIONS. This chapter does not apply to:

(1) a health benefit plan that provides coverage only:

(A) for a specified disease or diseases or under a limited

benefit policy;

(B) for accidental death or dismemberment;

(C) as a supplement to a liability insurance policy; or

(D) for dental or vision care;

(2) disability income insurance coverage;

(3) credit insurance coverage;

(4) a hospital confinement indemnity policy;

(5) a Medicare supplemental policy as defined by Section

1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss);

(6) a workers' compensation insurance policy;

(7) medical payment insurance coverage provided under a motor

vehicle insurance policy;

(8) a long-term care insurance policy, including a nursing home

fixed indemnity policy, unless the commissioner determines that

the policy provides benefits so comprehensive that the policy is

a health benefit plan and should not be subject to the exemption

provided under this section;

(9) the child health plan program under Chapter 62, Health and

Safety Code, or the health benefits plan for children under

Chapter 63, Health and Safety Code; or

(10) a Medicaid managed care program operated under Chapter 533,

Government Code, or a Medicaid program operated under Chapter 32,

Human Resources Code.

Added by Acts 2009, 81st Leg., R.S., Ch.

261, Sec. 1, eff. May 30, 2009.

Sec. 1661.004. REQUIRED USE OF TECHNOLOGY BY PROVIDERS. A

physician, hospital, or other health care provider shall use

information technology as required under this chapter beginning

not later than September 1, 2013.

Added by Acts 2009, 81st Leg., R.S., Ch.

261, Sec. 1, eff. May 30, 2009.

Sec. 1661.005. REFUND OF OVERPAYMENT. A physician, hospital, or

other health care provider that receives an overpayment from an

enrollee must refund the amount of the overpayment to the

enrollee not later than the 30th day after the date the

physician, hospital, or health care provider determines that an

overpayment has been made. This section does not apply to an

overpayment subject to Section 843.350 or 1301.132.

Added by Acts 2009, 81st Leg., R.S., Ch.

261, Sec. 1, eff. May 30, 2009.

Sec. 1661.0055. USE OF TECHNOLOGY: WAIVER. (a) Notwithstanding

Section 1661.004, physicians or health care providers with fewer

than five full-time-equivalent employees are not required to use

information technology as required under this chapter.

(b) A health benefit plan issuer may not require, through

contract or otherwise, physicians or health care providers with

fewer than five full-time-equivalent employees to use information

technology as required under this chapter.

(c) A contract between the issuer of a health benefit plan and a

physician or health care provider must provide for a waiver of

any requirement for the use of information technology as

established or required under this chapter.

(d) The commissioner shall establish the circumstances under

which the requirements of this chapter do not apply to a

physician or health care provider including:

(1) undue hardship, including fiscal or operational hardship; or

(2) any other special circumstance that would justify an

exclusion.

(e) The commissioner shall establish circumstances under which a

waiver under Subsection (c) is required, including:

(1) undue hardship, including fiscal or operational hardship; or

(2) any other special circumstance that would justify a waiver.

(f) Any physician or health care provider that is denied a

waiver by a health benefit plan issuer may appeal the denial to

the commissioner. The commissioner shall determine whether a

waiver must be granted.

(g) A health benefit plan issuer may not refuse to contract or

renew a contract with a physician or health care provider based

in whole or in part on the physician or provider requesting or

receiving a waiver or appealing a waiver determination. A health

benefit plan issuer may not refuse to contract or renew a

contract with a physician or health care provider based in whole

or in part on the physician or provider meeting the exemptions

contained in Subsections (a) and (b).

(h) A waiver approved under this section expires September 1,

2013.

Added by Acts 2009, 81st Leg., R.S., Ch.

261, Sec. 1, eff. May 30, 2009.

Sec. 1661.006. HEALTH BENEFIT PLAN ISSUER CONDUCT. A contract

between a health benefit plan issuer and a physician, hospital,

or other health care provider may not prohibit the physician,

hospital, or health care provider from collecting, at the time of

care, the estimated amount for which the enrollee may be

financially responsible.

Added by Acts 2009, 81st Leg., R.S., Ch.

261, Sec. 1, eff. May 30, 2009.

Sec. 1661.007. CERTAIN FEES PROHIBITED. A health benefit plan

issuer may not directly charge or collect from an enrollee or a

physician, or other health care provider, a fee to cover the

costs incurred by the health benefit plan issuer in complying

with this chapter.

Added by Acts 2009, 81st Leg., R.S., Ch.

261, Sec. 1, eff. May 30, 2009.

For expiration of this section, see Subsection (d).

Sec. 1661.008. WAIVER. (a) A health benefit plan issuer may

apply to the commissioner for a waiver of the requirement under

this chapter to use information technology.

(b) The commissioner by rule shall identify circumstances that

justify a waiver, including:

(1) undue hardship, including financial or operational hardship;

(2) the geographical area in which the health benefit plan

issuer operates;

(3) the number of enrollees covered by a health benefit plan

issuer; and

(4) other special circumstances.

(c) The commissioner shall approve or deny a waiver application

under this section not later than the 60th day after the date of

receipt of the application.

(d) This section expires January 1, 2012.

(e) A waiver approved under this section expires September 1,

2013.

Added by Acts 2009, 81st Leg., R.S., Ch.

261, Sec. 1, eff. May 30, 2009.

Sec. 1661.009. RULES. (a) The commissioner shall adopt rules as

necessary to implement this chapter, including rules that ensure

that the information technology used by a health benefit plan

issuer does not have legal or technical restrictions for

encoding, displaying, exchanging, reading, printing,

transmitting, or storing information or data in electronic form.

(b) Rules adopted by the commissioner must be consistent with

national standards established by the Workgroup for Electronic

Data Interchange or by other similar organizations recognized by

the commissioner.

Added by Acts 2009, 81st Leg., R.S., Ch.

261, Sec. 1, eff. May 30, 2009.

State Codes and Statutes

Statutes > Texas > Insurance-code > Title-8-health-insurance-and-other-health-coverages > Chapter-1661-information-technology

INSURANCE CODE

TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES

SUBTITLE J. HEALTH INFORMATION TECHNOLOGY

CHAPTER 1661. INFORMATION TECHNOLOGY

Sec. 1661.001. DEFINITIONS. In this chapter:

(1) "Health benefit plan" means a plan that provides benefits

for medical or surgical expenses incurred as a result of a health

condition, accident, or sickness, including an individual, group,

blanket, or franchise insurance policy or insurance agreement, a

group hospital service contract, or an individual or group

evidence of coverage that is offered by:

(A) an insurance company;

(B) a group hospital service corporation operating under Chapter

842;

(C) a fraternal benefit society operating under Chapter 885;

(D) a stipulated premium company operating under Chapter 884;

(E) a Lloyd's plan operating under Chapter 941;

(F) an exchange operating under Chapter 942;

(G) a health maintenance organization operating under Chapter

843;

(H) a multiple employer welfare arrangement that holds a

certificate of authority under Chapter 846;

(I) an approved nonprofit health corporation that holds a

certificate of authority under Chapter 844; or

(J) an entity not authorized under this code or another

insurance law of this state that contracts directly for health

care services on a risk-sharing basis, including a capitation

basis.

(2) "Health benefit plan issuer" means an entity authorized to

issue a health benefit plan in this state.

(3) "Health care provider" means:

(A) an individual who is licensed, certified, or otherwise

authorized to provide health care services; or

(B) a hospital, emergency clinic, outpatient clinic, or other

facility providing health care services.

(4) "Participating provider" means a health care provider who

has contracted with a health benefit plan issuer to provide

services to enrollees.

Added by Acts 2009, 81st Leg., R.S., Ch.

261, Sec. 1, eff. May 30, 2009.

Sec. 1661.002. USE OF CERTAIN INFORMATION TECHNOLOGY REQUIRED.

(a) A health benefit plan issuer shall use information

technology that provides a participating provider with real-time

information at the point of care concerning:

(1) the enrollee's:

(A) copayment and coinsurance;

(B) applicable deductibles; and

(C) covered benefits and services; and

(2) the enrollee's estimated total financial responsibility for

the care.

(b) A health benefit plan issuer shall use information

technology that provides an enrollee with information concerning

the enrollee's:

(1) copayment and coinsurance;

(2) applicable deductibles;

(3) covered benefits and services; and

(4) estimated financial responsibility for the health care

provided to the enrollee.

(c) Nothing in this section may be interpreted as a guarantee of

payment for health care services.

(d) A health benefit plan issuer's Internet website may be used

to meet the information technology requirements of this chapter.

Added by Acts 2009, 81st Leg., R.S., Ch.

261, Sec. 1, eff. May 30, 2009.

Sec. 1661.003. EXCEPTIONS. This chapter does not apply to:

(1) a health benefit plan that provides coverage only:

(A) for a specified disease or diseases or under a limited

benefit policy;

(B) for accidental death or dismemberment;

(C) as a supplement to a liability insurance policy; or

(D) for dental or vision care;

(2) disability income insurance coverage;

(3) credit insurance coverage;

(4) a hospital confinement indemnity policy;

(5) a Medicare supplemental policy as defined by Section

1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss);

(6) a workers' compensation insurance policy;

(7) medical payment insurance coverage provided under a motor

vehicle insurance policy;

(8) a long-term care insurance policy, including a nursing home

fixed indemnity policy, unless the commissioner determines that

the policy provides benefits so comprehensive that the policy is

a health benefit plan and should not be subject to the exemption

provided under this section;

(9) the child health plan program under Chapter 62, Health and

Safety Code, or the health benefits plan for children under

Chapter 63, Health and Safety Code; or

(10) a Medicaid managed care program operated under Chapter 533,

Government Code, or a Medicaid program operated under Chapter 32,

Human Resources Code.

Added by Acts 2009, 81st Leg., R.S., Ch.

261, Sec. 1, eff. May 30, 2009.

Sec. 1661.004. REQUIRED USE OF TECHNOLOGY BY PROVIDERS. A

physician, hospital, or other health care provider shall use

information technology as required under this chapter beginning

not later than September 1, 2013.

Added by Acts 2009, 81st Leg., R.S., Ch.

261, Sec. 1, eff. May 30, 2009.

Sec. 1661.005. REFUND OF OVERPAYMENT. A physician, hospital, or

other health care provider that receives an overpayment from an

enrollee must refund the amount of the overpayment to the

enrollee not later than the 30th day after the date the

physician, hospital, or health care provider determines that an

overpayment has been made. This section does not apply to an

overpayment subject to Section 843.350 or 1301.132.

Added by Acts 2009, 81st Leg., R.S., Ch.

261, Sec. 1, eff. May 30, 2009.

Sec. 1661.0055. USE OF TECHNOLOGY: WAIVER. (a) Notwithstanding

Section 1661.004, physicians or health care providers with fewer

than five full-time-equivalent employees are not required to use

information technology as required under this chapter.

(b) A health benefit plan issuer may not require, through

contract or otherwise, physicians or health care providers with

fewer than five full-time-equivalent employees to use information

technology as required under this chapter.

(c) A contract between the issuer of a health benefit plan and a

physician or health care provider must provide for a waiver of

any requirement for the use of information technology as

established or required under this chapter.

(d) The commissioner shall establish the circumstances under

which the requirements of this chapter do not apply to a

physician or health care provider including:

(1) undue hardship, including fiscal or operational hardship; or

(2) any other special circumstance that would justify an

exclusion.

(e) The commissioner shall establish circumstances under which a

waiver under Subsection (c) is required, including:

(1) undue hardship, including fiscal or operational hardship; or

(2) any other special circumstance that would justify a waiver.

(f) Any physician or health care provider that is denied a

waiver by a health benefit plan issuer may appeal the denial to

the commissioner. The commissioner shall determine whether a

waiver must be granted.

(g) A health benefit plan issuer may not refuse to contract or

renew a contract with a physician or health care provider based

in whole or in part on the physician or provider requesting or

receiving a waiver or appealing a waiver determination. A health

benefit plan issuer may not refuse to contract or renew a

contract with a physician or health care provider based in whole

or in part on the physician or provider meeting the exemptions

contained in Subsections (a) and (b).

(h) A waiver approved under this section expires September 1,

2013.

Added by Acts 2009, 81st Leg., R.S., Ch.

261, Sec. 1, eff. May 30, 2009.

Sec. 1661.006. HEALTH BENEFIT PLAN ISSUER CONDUCT. A contract

between a health benefit plan issuer and a physician, hospital,

or other health care provider may not prohibit the physician,

hospital, or health care provider from collecting, at the time of

care, the estimated amount for which the enrollee may be

financially responsible.

Added by Acts 2009, 81st Leg., R.S., Ch.

261, Sec. 1, eff. May 30, 2009.

Sec. 1661.007. CERTAIN FEES PROHIBITED. A health benefit plan

issuer may not directly charge or collect from an enrollee or a

physician, or other health care provider, a fee to cover the

costs incurred by the health benefit plan issuer in complying

with this chapter.

Added by Acts 2009, 81st Leg., R.S., Ch.

261, Sec. 1, eff. May 30, 2009.

For expiration of this section, see Subsection (d).

Sec. 1661.008. WAIVER. (a) A health benefit plan issuer may

apply to the commissioner for a waiver of the requirement under

this chapter to use information technology.

(b) The commissioner by rule shall identify circumstances that

justify a waiver, including:

(1) undue hardship, including financial or operational hardship;

(2) the geographical area in which the health benefit plan

issuer operates;

(3) the number of enrollees covered by a health benefit plan

issuer; and

(4) other special circumstances.

(c) The commissioner shall approve or deny a waiver application

under this section not later than the 60th day after the date of

receipt of the application.

(d) This section expires January 1, 2012.

(e) A waiver approved under this section expires September 1,

2013.

Added by Acts 2009, 81st Leg., R.S., Ch.

261, Sec. 1, eff. May 30, 2009.

Sec. 1661.009. RULES. (a) The commissioner shall adopt rules as

necessary to implement this chapter, including rules that ensure

that the information technology used by a health benefit plan

issuer does not have legal or technical restrictions for

encoding, displaying, exchanging, reading, printing,

transmitting, or storing information or data in electronic form.

(b) Rules adopted by the commissioner must be consistent with

national standards established by the Workgroup for Electronic

Data Interchange or by other similar organizations recognized by

the commissioner.

Added by Acts 2009, 81st Leg., R.S., Ch.

261, Sec. 1, eff. May 30, 2009.


State Codes and Statutes


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State Codes and Statutes

Statutes > Texas > Insurance-code > Title-8-health-insurance-and-other-health-coverages > Chapter-1661-information-technology

INSURANCE CODE

TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES

SUBTITLE J. HEALTH INFORMATION TECHNOLOGY

CHAPTER 1661. INFORMATION TECHNOLOGY

Sec. 1661.001. DEFINITIONS. In this chapter:

(1) "Health benefit plan" means a plan that provides benefits

for medical or surgical expenses incurred as a result of a health

condition, accident, or sickness, including an individual, group,

blanket, or franchise insurance policy or insurance agreement, a

group hospital service contract, or an individual or group

evidence of coverage that is offered by:

(A) an insurance company;

(B) a group hospital service corporation operating under Chapter

842;

(C) a fraternal benefit society operating under Chapter 885;

(D) a stipulated premium company operating under Chapter 884;

(E) a Lloyd's plan operating under Chapter 941;

(F) an exchange operating under Chapter 942;

(G) a health maintenance organization operating under Chapter

843;

(H) a multiple employer welfare arrangement that holds a

certificate of authority under Chapter 846;

(I) an approved nonprofit health corporation that holds a

certificate of authority under Chapter 844; or

(J) an entity not authorized under this code or another

insurance law of this state that contracts directly for health

care services on a risk-sharing basis, including a capitation

basis.

(2) "Health benefit plan issuer" means an entity authorized to

issue a health benefit plan in this state.

(3) "Health care provider" means:

(A) an individual who is licensed, certified, or otherwise

authorized to provide health care services; or

(B) a hospital, emergency clinic, outpatient clinic, or other

facility providing health care services.

(4) "Participating provider" means a health care provider who

has contracted with a health benefit plan issuer to provide

services to enrollees.

Added by Acts 2009, 81st Leg., R.S., Ch.

261, Sec. 1, eff. May 30, 2009.

Sec. 1661.002. USE OF CERTAIN INFORMATION TECHNOLOGY REQUIRED.

(a) A health benefit plan issuer shall use information

technology that provides a participating provider with real-time

information at the point of care concerning:

(1) the enrollee's:

(A) copayment and coinsurance;

(B) applicable deductibles; and

(C) covered benefits and services; and

(2) the enrollee's estimated total financial responsibility for

the care.

(b) A health benefit plan issuer shall use information

technology that provides an enrollee with information concerning

the enrollee's:

(1) copayment and coinsurance;

(2) applicable deductibles;

(3) covered benefits and services; and

(4) estimated financial responsibility for the health care

provided to the enrollee.

(c) Nothing in this section may be interpreted as a guarantee of

payment for health care services.

(d) A health benefit plan issuer's Internet website may be used

to meet the information technology requirements of this chapter.

Added by Acts 2009, 81st Leg., R.S., Ch.

261, Sec. 1, eff. May 30, 2009.

Sec. 1661.003. EXCEPTIONS. This chapter does not apply to:

(1) a health benefit plan that provides coverage only:

(A) for a specified disease or diseases or under a limited

benefit policy;

(B) for accidental death or dismemberment;

(C) as a supplement to a liability insurance policy; or

(D) for dental or vision care;

(2) disability income insurance coverage;

(3) credit insurance coverage;

(4) a hospital confinement indemnity policy;

(5) a Medicare supplemental policy as defined by Section

1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss);

(6) a workers' compensation insurance policy;

(7) medical payment insurance coverage provided under a motor

vehicle insurance policy;

(8) a long-term care insurance policy, including a nursing home

fixed indemnity policy, unless the commissioner determines that

the policy provides benefits so comprehensive that the policy is

a health benefit plan and should not be subject to the exemption

provided under this section;

(9) the child health plan program under Chapter 62, Health and

Safety Code, or the health benefits plan for children under

Chapter 63, Health and Safety Code; or

(10) a Medicaid managed care program operated under Chapter 533,

Government Code, or a Medicaid program operated under Chapter 32,

Human Resources Code.

Added by Acts 2009, 81st Leg., R.S., Ch.

261, Sec. 1, eff. May 30, 2009.

Sec. 1661.004. REQUIRED USE OF TECHNOLOGY BY PROVIDERS. A

physician, hospital, or other health care provider shall use

information technology as required under this chapter beginning

not later than September 1, 2013.

Added by Acts 2009, 81st Leg., R.S., Ch.

261, Sec. 1, eff. May 30, 2009.

Sec. 1661.005. REFUND OF OVERPAYMENT. A physician, hospital, or

other health care provider that receives an overpayment from an

enrollee must refund the amount of the overpayment to the

enrollee not later than the 30th day after the date the

physician, hospital, or health care provider determines that an

overpayment has been made. This section does not apply to an

overpayment subject to Section 843.350 or 1301.132.

Added by Acts 2009, 81st Leg., R.S., Ch.

261, Sec. 1, eff. May 30, 2009.

Sec. 1661.0055. USE OF TECHNOLOGY: WAIVER. (a) Notwithstanding

Section 1661.004, physicians or health care providers with fewer

than five full-time-equivalent employees are not required to use

information technology as required under this chapter.

(b) A health benefit plan issuer may not require, through

contract or otherwise, physicians or health care providers with

fewer than five full-time-equivalent employees to use information

technology as required under this chapter.

(c) A contract between the issuer of a health benefit plan and a

physician or health care provider must provide for a waiver of

any requirement for the use of information technology as

established or required under this chapter.

(d) The commissioner shall establish the circumstances under

which the requirements of this chapter do not apply to a

physician or health care provider including:

(1) undue hardship, including fiscal or operational hardship; or

(2) any other special circumstance that would justify an

exclusion.

(e) The commissioner shall establish circumstances under which a

waiver under Subsection (c) is required, including:

(1) undue hardship, including fiscal or operational hardship; or

(2) any other special circumstance that would justify a waiver.

(f) Any physician or health care provider that is denied a

waiver by a health benefit plan issuer may appeal the denial to

the commissioner. The commissioner shall determine whether a

waiver must be granted.

(g) A health benefit plan issuer may not refuse to contract or

renew a contract with a physician or health care provider based

in whole or in part on the physician or provider requesting or

receiving a waiver or appealing a waiver determination. A health

benefit plan issuer may not refuse to contract or renew a

contract with a physician or health care provider based in whole

or in part on the physician or provider meeting the exemptions

contained in Subsections (a) and (b).

(h) A waiver approved under this section expires September 1,

2013.

Added by Acts 2009, 81st Leg., R.S., Ch.

261, Sec. 1, eff. May 30, 2009.

Sec. 1661.006. HEALTH BENEFIT PLAN ISSUER CONDUCT. A contract

between a health benefit plan issuer and a physician, hospital,

or other health care provider may not prohibit the physician,

hospital, or health care provider from collecting, at the time of

care, the estimated amount for which the enrollee may be

financially responsible.

Added by Acts 2009, 81st Leg., R.S., Ch.

261, Sec. 1, eff. May 30, 2009.

Sec. 1661.007. CERTAIN FEES PROHIBITED. A health benefit plan

issuer may not directly charge or collect from an enrollee or a

physician, or other health care provider, a fee to cover the

costs incurred by the health benefit plan issuer in complying

with this chapter.

Added by Acts 2009, 81st Leg., R.S., Ch.

261, Sec. 1, eff. May 30, 2009.

For expiration of this section, see Subsection (d).

Sec. 1661.008. WAIVER. (a) A health benefit plan issuer may

apply to the commissioner for a waiver of the requirement under

this chapter to use information technology.

(b) The commissioner by rule shall identify circumstances that

justify a waiver, including:

(1) undue hardship, including financial or operational hardship;

(2) the geographical area in which the health benefit plan

issuer operates;

(3) the number of enrollees covered by a health benefit plan

issuer; and

(4) other special circumstances.

(c) The commissioner shall approve or deny a waiver application

under this section not later than the 60th day after the date of

receipt of the application.

(d) This section expires January 1, 2012.

(e) A waiver approved under this section expires September 1,

2013.

Added by Acts 2009, 81st Leg., R.S., Ch.

261, Sec. 1, eff. May 30, 2009.

Sec. 1661.009. RULES. (a) The commissioner shall adopt rules as

necessary to implement this chapter, including rules that ensure

that the information technology used by a health benefit plan

issuer does not have legal or technical restrictions for

encoding, displaying, exchanging, reading, printing,

transmitting, or storing information or data in electronic form.

(b) Rules adopted by the commissioner must be consistent with

national standards established by the Workgroup for Electronic

Data Interchange or by other similar organizations recognized by

the commissioner.

Added by Acts 2009, 81st Leg., R.S., Ch.

261, Sec. 1, eff. May 30, 2009.


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