Section 843.351 - Services Provided By Certain Physicians and Providers The provisions of this subchapter relating to prompt payment by a health maintenance organization of a physician or provider and to verification of health care services apply to a physician or provider who:
(1) is not included in the health maintenance organization delivery network; and(2) provides to an enrollee: (A) care related to an emergency or its attendant episode of care as required by state or federal law; or(B) specialty or other health care services at the request of the health maintenance organization or a physician or provider who is included in the health maintenance organization delivery network because the services are not reasonably available within the network.Added by Acts 2003, 78th Leg., ch. 214, Sec. 19, eff. 6/17/2003.