State Law

Texas Statutes-Insurance Code-Title 6-Subtitle C-Chapter 843-Subchapter I. Relations with Physicians and Providers

08/24/2023 Texas Section 843.313

Economic Profiling


(a) A health maintenance organization that conducts or uses economic profiling of physicians or providers participating in the health maintenance organization delivery network shall make available to a network physician or provider on request that physician’s or provider’s economic profile, including the standards by which the physician or provider is measured.

(b) The use of an economic profile must recognize the characteristics of a physician’s or provider’s practice that may account for variations from expected costs.