reglab/housing_qa huggingface dataset:
TX Ins Code § 843.410 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 843 - Health Maintenance Organizations|Subchapter L. Financial Regulation of Health Maintenance Organizations|Section 843.410. Assessments

Sec. 843.410.  ASSESSMENTS.  (a)  To provide funds for the administrative expenses of the commissioner regarding rehabilitation, liquidation, supervision, conservatorship, or seizure of a health maintenance organization in this state that is placed under supervision or in conservatorship under Chapter 441 or against which a delinquency proceeding is commenced under Chapter 443 and that is found by the commissioner to have insufficient funds to pay the total amount of health care claims and the administrative expenses incurred by the commissioner regarding the rehabilitation, liquidation, supervision, conservatorship, or seizure, the commissioner shall assess each health maintenance organization in the proportion that the gross premiums of the health maintenance organization that were written in this state during the preceding calendar year bear to the aggregate gross premiums that were written in this state by all health maintenance organizations, as found after review of annual statements and other reports the commissioner considers necessary.(b)  The commissioner may abate or defer an assessment in whole or in part if, in the opinion of the commissioner, payment of the assessment would endanger the ability of a health maintenance organization to fulfill its contractual obligations.  If an assessment is abated or deferred in whole or in part, the amount of the abatement or deferral may be assessed against the remaining health maintenance organizations in a manner consistent with the calculations made by the commissioner under Subsection (a).(c)  The total of all assessments on a health maintenance organization may not exceed one-fourth of one percent of the health maintenance organization's gross premiums in any one calendar year.(d)  Notwithstanding any other provision of this subchapter, funds derived from an assessment made under this section may not be used for more than 180 consecutive days for the expenses of administering the affairs of a health maintenance organization the surplus of which is impaired and that is in supervision or conservatorship.  The commissioner may extend the period during which the commissioner makes assessments for the administrative expenses.|Transferred, redesignated and amended from Insurance Code, Section 843.441 by Acts 2011, 82nd Leg., R.S., Ch. 1147 (H.B. 1951), Sec. 2.002, eff. September 1, 2011.|
TX Ins Code § 843.462 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 843 - Health Maintenance Organizations|Subchapter N. Enforcement|Section 843.462. Operations During Suspension or After Revocation of Certificate of Authority

Sec. 843.462.  OPERATIONS DURING SUSPENSION OR AFTER REVOCATION OF CERTIFICATE OF AUTHORITY.  (a)  During the period a certificate of authority of a health maintenance organization is suspended, the health maintenance organization may not:(1)  enroll additional enrollees except newborn children or other newly acquired dependents of existing enrollees;  or(2)  advertise or solicit in any way.(b)  After a certificate of authority of a health maintenance organization is revoked, the health maintenance organization:(1)  shall proceed, immediately following the effective date of the order of revocation, to conclude its affairs;(2)  may not conduct further business except as essential to the orderly conclusion of its affairs;  and(3)  may not advertise or solicit in any way.(c)  Notwithstanding Subsection (b), the commissioner may, by written order, permit the further operation of the health maintenance organization to the extent that the commissioner finds necessary to serve the best interest of enrollees and to provide enrollees with the greatest practical opportunity to obtain continuing health care coverage.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 843.463 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 843 - Health Maintenance Organizations|Subchapter N. Enforcement|Section 843.463. Injunctions

Sec. 843.463.  INJUNCTIONS.  If the commissioner believes that a health maintenance organization or another person is violating or has violated this chapter or a rule adopted under this chapter or Section 1367.053, Subchapter A, Chapter 1452, Subchapter B, Chapter 1507, Chapter 222, 251, or 258, as applicable to a health maintenance organization, or Chapter 1271 or 1272 or a rule adopted under one of those provisions, the commissioner may bring an action in a Travis County district court to enjoin the violation and obtain other relief the court considers appropriate.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.Amended by: Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 2E.053, eff. April 1, 2009.|
TX Ins Code § 843.464 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 843 - Health Maintenance Organizations|Subchapter N. Enforcement|Section 843.464. Criminal Penalty

Sec. 843.464.  CRIMINAL PENALTY.  (a)  A person, including an agent or officer of a health maintenance organization, commits an offense if the person:(1)  wilfully violates this chapter or a rule adopted under this chapter or Section 1367.053, Subchapter A, Chapter 1452, Subchapter B, Chapter 1507, Chapter 222, 251, or 258, as applicable to a health maintenance organization, or Chapter 1271 or 1272 or a rule adopted under one of those provisions; or(2)  knowingly makes a false statement with respect to a report or statement required under this chapter or Section 1367.053, Subchapter A, Chapter 1452, Subchapter B, Chapter 1507, Chapter 222, 251, or 258, as applicable to a health maintenance organization, or Chapter 1271 or 1272.(b)  An offense under this section is a Class B misdemeanor.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.Amended by: Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 2E.054, eff. April 1, 2009.|
TX Ins Code § 844.001 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 844 - Certification of Certain Nonprofit Health Corporations|Subchapter A. General Provisions|Section 844.001. Definitions

Sec. 844.001.  DEFINITIONS.  In this chapter:(1)  "Approved nonprofit health corporation" means a nonprofit health corporation certified under Section 162.001, Occupations Code.(2)  "Certificate holder" means an approved nonprofit health corporation that holds a certificate of authority issued under this chapter.(3)  "Health care plan" has the meaning assigned by Section 843.002.(4)  "Health maintenance organization" means a health maintenance organization licensed under Chapter 843.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 844.002 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 844 - Certification of Certain Nonprofit Health Corporations|Subchapter A. General Provisions|Section 844.002. Exceptions

Sec. 844.002.  EXCEPTIONS.  This chapter does not apply to:(1)  an approved nonprofit health corporation that contracts to arrange for or provide health care services on a fee-for-service basis;(2)  a contract entered into by a certificate holder to arrange for or provide health care services on a fee-for-service basis;  or(3)  an activity exempt from regulation under Section 843.053 or 843.073.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 844.003 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 844 - Certification of Certain Nonprofit Health Corporations|Subchapter A. General Provisions|Section 844.003. Exceptions to Texas Health Maintenance Organization Act

Sec. 844.003.  EXCEPTIONS TO TEXAS HEALTH MAINTENANCE ORGANIZATION ACT.  This chapter may not be construed to alter the exceptions stated in Sections 843.053 and 843.073.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 844.004 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 844 - Certification of Certain Nonprofit Health Corporations|Subchapter A. General Provisions|Section 844.004. Rules

Sec. 844.004.  RULES.  Except as provided by Section 844.101(b), the commissioner shall adopt rules to implement this chapter.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 844.005 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 844 - Certification of Certain Nonprofit Health Corporations|Subchapter A. General Provisions|Section 844.005. Provision of Certain Services on Behalf of Health Maintenance Organizations

Sec. 844.005.  PROVISION OF CERTAIN SERVICES ON BEHALF OF HEALTH MAINTENANCE ORGANIZATIONS.  (a)  An approved nonprofit health corporation may arrange for or provide health care services on a risk-sharing or capitated risk arrangement on behalf of a health maintenance organization.(b)  An approved nonprofit health corporation is not required to obtain a certificate of authority under this chapter or under Chapter 843 to arrange for or provide health care services as provided by Subsection (a).|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 844.051 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 844 - Certification of Certain Nonprofit Health Corporations|Subchapter B. Authority to Engage in Business|Section 844.051. Certificate of Authority Required

Sec. 844.051.  CERTIFICATE OF AUTHORITY REQUIRED.  An approved nonprofit health corporation may not arrange for or provide a health care plan to enrollees on a prepaid basis unless the corporation holds a certificate of authority issued under this chapter.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 844.052 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 844 - Certification of Certain Nonprofit Health Corporations|Subchapter B. Authority to Engage in Business|Section 844.052. Certificate Application; Eligibility Requirements

Sec. 844.052.  CERTIFICATE APPLICATION;  ELIGIBILITY REQUIREMENTS.  (a)  An approved nonprofit health corporation may apply to the department for a certificate of authority under this chapter.(b)  The commissioner may issue a certificate of authority only to an applicant that:(1)  meets the same requirements for the issuance of a certificate of authority that a health maintenance organization is required to meet under Chapter 843;  and(2)  establishes accreditation by:(A)  the National Committee on Quality Assurance;(B)  the Joint Commission on Accreditation of Healthcare Organization's accreditation for health care networks;  or(C)  an accrediting organization recognized by rule of the commissioner.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 844.053 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 844 - Certification of Certain Nonprofit Health Corporations|Subchapter B. Authority to Engage in Business|Section 844.053. Provisional Certificate of Authority

Sec. 844.053.  PROVISIONAL CERTIFICATE OF AUTHORITY.  The commissioner shall grant a provisional certificate of authority to an applicant if:(1)  the applicant has applied for accreditation from an accrediting organization described by Section 844.052(b)(2);(2)  the applicant is diligently pursuing accreditation;(3)  the accrediting organization has not denied the application for accreditation;  and(4)  the applicant satisfies each other requirement of this chapter.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 844.054 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 844 - Certification of Certain Nonprofit Health Corporations|Subchapter B. Authority to Engage in Business|Section 844.054. Powers and Duties of Certificate Holder

Sec. 844.054.  POWERS AND DUTIES OF CERTIFICATE HOLDER.  (a)  A certificate holder has all the powers granted to and duties imposed on a health maintenance organization under the insurance laws of this state, including Chapter 843, and is subject to regulation and regulatory enforcement under those laws in the same manner as a health maintenance organization.(b)  A certificate holder shall maintain accreditation as described by Section 844.052(b)(2).|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 844.101 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 844 - Certification of Certain Nonprofit Health Corporations|Subchapter C. Prohibited Conduct|Section 844.101. Unfair Competition

Sec. 844.101.  UNFAIR COMPETITION.  (a)  A certificate holder may not engage in unfair and disruptive provider hiring or contracting practices for the purpose of limiting competition from traditional community providers.(b)  The Texas State Board of Medical Examiners shall adopt rules to implement this section.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 845.001 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 845 - Statewide Rural Health Care System|Subchapter A. General Provisions|Section 845.001. Short Title

Sec. 845.001.  SHORT TITLE.  This chapter may be cited as the Statewide Rural Health Care System Act.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 845.002 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 845 - Statewide Rural Health Care System|Subchapter A. General Provisions|Section 845.002. Definitions

Sec. 845.002.  DEFINITIONS.  In this chapter:(1)  "Board" means the board of directors of the system.(2)  "Enrollee" means an individual who:(A)  resides in a rural area;  and(B)  is entitled to receive health care services through a health care plan sponsored by, arranged for, or provided by the system.(3)  "Health care services" has the meaning assigned by Section 843.002.(4)  "Health care provider" means a physician, facility, practitioner, or other person or organization who, under a license or grant of authority issued by this state, provides care or supplies to individuals under a health benefit plan.  The term does not include a hospital provider.(5)  "Hospital provider" means a county hospital, county hospital authority, hospital district, municipal hospital, or municipal hospital authority.(6)  "Local health care provider" means:(A)  a person licensed, registered, or certified as a health care practitioner in this state who resides or practices in a rural area in which the person provides health care services;  or(B)  a general or specialty hospital that is not a hospital provider under this chapter.(7)  "Participating hospital provider" means a hospital provider that participates in the system.(8)  "Person" means an individual, professional association, professional corporation, partnership, limited liability corporation, limited liability partnership, or nonprofit corporation, including a nonprofit corporation certified under Section 162.001, Occupations Code.(9)  "Rural area" means:(A)  a county with a population of 50,000 or less;(B)  an area that is not delineated as an urbanized area by the United States Bureau of the Census;  or(C)  any other area designated as rural by a rule adopted by the commissioner, subject to Section 845.003.(10)  "System" means the statewide rural health care system established under this chapter.(11)  "Territorial jurisdiction" means the geographical area in which a participating hospital provider is obligated by law to provide health care services.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.  Amended by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.213(a), eff. Sept. 1, 2003.|
TX Ins Code § 845.003 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 845 - Statewide Rural Health Care System|Subchapter A. General Provisions|Section 845.003. Rural Area Designation

Sec. 845.003.  RURAL AREA DESIGNATION.  In determining whether to designate an area as a rural area under this chapter, the commissioner shall consider any area that is delineated as an urbanized area by the United States Bureau of the Census and:(1)  is contiguous with and not more than 10 miles away from a rural area described by Section 845.002(9)(A) or (B);(2)  is sparsely populated, compared to areas within a 10-mile radius that are delineated as urbanized areas by the United States Bureau of the Census;(3)  has not increased in population in any single calendar year in the seven years before the commissioner makes the designation;  and(4)  in which emergency or primary care services:(A)  are limited or unavailable in accordance with network access standards imposed by the commissioner;  and(B)  would be made materially more accessible by allowing access to care in a contiguous area that is otherwise eligible to participate in the system.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.  Amended by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.213(b), eff. Sept. 1, 2003.|
TX Ins Code § 845.004 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 845 - Statewide Rural Health Care System|Subchapter A. General Provisions|Section 845.004. Rules

Sec. 845.004.  RULES.  The commissioner shall adopt rules as necessary to implement this subchapter and Subchapters B, C, and D.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.  Amended by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.218(b), eff. Sept. 1, 2003.|
TX Ins Code § 845.051 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 845 - Statewide Rural Health Care System|Subchapter B. System|Section 845.051. Statewide Rural Health Care System

Sec. 845.051.  STATEWIDE RURAL HEALTH CARE SYSTEM.  The commissioner shall designate a single organization as the statewide rural health care system.  The system is authorized to sponsor, arrange for the provision of, or provide health care services to enrollees in programs in rural areas.  The programs are not subject to:(1)  a law requiring the coverage or the offer of coverage for services by a particular health care provider under:(A)  Chapter 62, Health and Safety Code;(B)  Chapter 32, Human Resources Code;(C)  a state-, county-, or local government-sponsored indigent care initiative; or(D)  a federal Medicare Plus Choice program; or(2)  Subchapters A-I, Chapter 1251, Subchapter A, Chapter 1364, Subchapter A, Chapter 1366, or Section 1551.064 under a state-, county-, or local government-sponsored uninsured or indigent care initiative.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.  Amended by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.214(a), eff. Sept. 1, 2003.Amended by: Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 2E.055, eff. April 1, 2009.|
TX Ins Code § 845.052 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 845 - Statewide Rural Health Care System|Subchapter B. System|Section 845.052. Organization Requirements

Sec. 845.052.  ORGANIZATION REQUIREMENTS.  The system must:(1)  be a corporation organized under the Texas Non-Profit Corporation Act (Article 1396-1.01 et seq., Vernon's Texas Civil Statutes);  and(2)  consist of a combination of two or more hospital providers, each of which:(A)  is a member of the corporation;  and(B)  is located in a rural area.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 845.053 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 845 - Statewide Rural Health Care System|Subchapter B. System|Section 845.053. Requirements Applicable to Certain Plans

Sec. 845.053.  REQUIREMENTS APPLICABLE TO CERTAIN PLANS.  (a)  Except as provided by Subsection (b), if the system seeks to sponsor, arrange for the provision of, or provide health care services to enrollees in exchange for a predetermined payment per enrollee on a prepaid basis, the system must comply with:(1)  all requirements under this code imposed on health plans, including health maintenance organizations;  and(2)  any additional requirements the commissioner determines are necessary to ensure enrollee access to health care providers and health care services.(b)  The system is not required to comply with requirements described by Subdivision (a)(1) that relate to mileage, distance, network adequacy, and scope of coverage that the commissioner determines are not applicable to the system.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.  Amended by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.214(a), eff. Sept. 1, 2003.|
TX Ins Code § 845.054 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 845 - Statewide Rural Health Care System|Subchapter B. System|Section 845.054. Local Government

Sec. 845.054.  LOCAL GOVERNMENT.  (a)  The system is:(1)  a unit of local government that is a governmental unit for purposes of Chapter 101, Civil Practice and Remedies Code;  and(2)  a local government for purposes of Chapter 102, Civil Practice and Remedies Code.(b)  The system may enter into interlocal cooperation contracts under Chapter 791, Government Code, and is a local government for purposes of that chapter.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|