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Texas Laws | Insurance Code
INSURANCE CODE
TITLE 5. PROTECTION OF CONSUMER INTERESTS

(c) The office shall provide a copy of any consumer report card on request on payment of a reasonable fee. (9391)

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005. (9392)

Sec. 501.253. ACCESS TO INFORMATION. (9393)(Text)

(a) The office is entitled to information that is confidential under a law of this state, including Section 843.006 of this code, Chapter 108, Health and Safety Code, and Chapter 552, Government Code. (9394)

(b) The department and the Texas Health Care Information Council shall provide any information or data as requested by the office in furtherance of the duties under this subchapter. (9395)

(c) The office shall use information collected or received under this subchapter for the benefit of the public. (9396)

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005. (9397)

Sec. 501.254. CONFIDENTIALITY AND USE OF INFORMATION. (9398)(Text)

(a) Except as provided by this section, information collected under this subchapter is subject to Chapter 552, Government Code, and the office shall make determinations on requests for information in favor of access. (9399)

(b) The office may not make public any confidential information provided to the office under this subchapter but may disclose a summary of the information that does not directly or indirectly identify the health maintenance organization that is the subject of the information. The office may not release, and a person or entity may not gain access to, any information that: (9400)

(1) could reasonably be expected to reveal the identity of a patient or physician; (9401)

(2) reveals the zip code of a patient's primary residence; (9402)

(3) discloses a provider discount or a differential between a payment and a billed charge; or (9403)

(4) relates to an actual payment made by a payer to an identified provider. (9404)

(c) Information collected or used by the office under this subchapter is subject to the confidentiality provisions and criminal penalties of: (9405)

(1) Section 81.103, Health and Safety Code; (9406)

(2) Section 311.037, Health and Safety Code; and (9407)

(3) Chapter 159, Occupations Code. (9408)

(d) Information on patients and physicians that is in the possession of the office and any compilation, report, or analysis produced from the information that identifies patients and physicians is not: (9409)

(1) subject to discovery, subpoena, or other means of legal compulsion for release to any person or entity; or (9410)

(2) admissible in any civil, administrative, or criminal proceeding. (9411)

(e) Notwithstanding Subsection (b)(2), the office may use zip code information to analyze information on a geographical basis. (9412)

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005. (9413)

SUBTITLE B. CONSUMER SERVICE PROVISIONS (9414)(Text)

CHAPTER 521. CONSUMER INFORMATION AND COMPLAINTS (9415)(Text)
SUBCHAPTER A. PUBLIC INTEREST INFORMATION AND COMPLAINT PROCEDURES (9416)(Text)
Sec. 521.001. PUBLIC INTEREST INFORMATION. (9417)(Text)

(a) The department shall prepare information of public interest describing the department's functions and the procedures by which complaints are filed with and resolved by the department. (9418)

(b) The department shall make the information available to the public and appropriate state agencies. (9419)

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005. (9420)

Sec. 521.002. COMPLAINT RESOLUTION PROGRAM. (9421)(Text)

The department shall establish a program to facilitate resolution of policyholder complaints. (9422)

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005. (9423)

Sec. 521.003. NOTIFICATION OF COMPLAINT STATUS. (9424)(Text)

If a written complaint is filed with the department, the department, at least quarterly and until final disposition of the complaint, shall notify each party to the complaint of the complaint's status unless the notice would jeopardize an undercover investigation. (9425)

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005. (9426)

Sec. 521.004. RECORDS OF COMPLAINTS. (9427)(Text)

The department shall keep an information file about each complaint filed with the department that concerns an activity regulated by the department or the commissioner. (9428)

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005. (9429)

Sec. 521.005. NOTICE TO ACCOMPANY POLICY. (9430)(Text)

(a) Each insurance policy delivered or issued for delivery in this state shall include with the policy a brief written notice that includes: (9431)

(1) a suggested procedure to be followed by a policyholder with a dispute concerning the policyholder's claim or premium; (9432)

(2) the department's name and address; and (9433)

(3) the department's toll-free telephone number maintained under Subchapter B. (9434)

(b) The commissioner shall adopt appropriate wording for the notice. (9435)

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005. (9436)

SUBCHAPTER B. DEPARTMENT TOLL-FREE NUMBER FOR INFORMATION AND COMPLAINTS (9437)(Text)

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