State Law

Texas Statutes-Insurance Code-Title 8-Subtitle F-Chapter 1467-Subchapter B-1. Mandatory Binding Arbitration for other Providers

08/24/2023 Texas Section 1467.089

Effect of Decision

OON-Payment Issues

(a) An arbitrator’s decision under Section 1467.088 is binding.

(b) Not later than the 45th day after the date of an arbitrator’s decision under Section 1467.088, a party not satisfied with the decision may file an action to determine the payment due to an out-of-network provider.

(c) In an action filed under Subsection (b), the court shall determine whether the arbitrator’s decision is proper based on a substantial evidence standard of review.

(d) Not later than the 30th day after the date of an arbitrator’s decision under Section 1467.088, a health benefit plan issuer or administrator shall pay to an out-of-network provider any additional amount necessary to satisfy the binding award.

See https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1467.htm#B-1