State Law

Texas Statutes-Insurance Code-Title 8-Subtitle D-Chapter 1301- Subchapter B. Relations with Physicians or Health Care Providers

08/24/2023 Texas Section 1301.067

Interference with Relationship Between Patient and Physician or Health Care Provider Prohibited

Anti-gag clause, Anti-retaliation

See bold sections below:

Anti-gag Clause

(a) An insurer may not, as a condition of a preferred provider contract with a physician or health care provider or in any other manner, prohibit, attempt to prohibit, or discourage a physician or provider from discussing with or communicating to a current, prospective, or former patient, or a person designated by a patient, information or an opinion:

(1) regarding the patient’s health care, including the patient’s medical condition or treatment options; or

(2) in good faith regarding the provisions, terms, requirements, or services of the health insurance policy as they relate to the patient’s medical needs.

(a-1) An insurer may not, as a condition of payment with a physician or health care provider or in any other manner, require a physician or health care provider to provide a notification form stating that the physician or health care provider is an out-of-network provider to a current, prospective, or former patient, or a person designated by the patient, if the form contains additional information that is intended, or is otherwise required to be presented in a manner that is intended, to intimidate the patient.

Anti-retaliation

(b) An insurer may not in any way penalize, terminate the participation of, or refuse to compensate for covered services a physician or health care provider for discussing or communicating with a current, prospective, or former patient, or a person designated by a patient, pursuant to this section.

See https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1301.htm