Sec. 1204.053. ASSIGNMENT OF BENEFITS.
(a) An insurer may not deliver, renew, or issue for delivery in this state a health insurance policy that prohibits or restricts a covered person from making a written assignment of benefits to a physician or other health care provider who provides health care services to the person.
(b) This section does not:
(1) provide a coverage or benefit that is not otherwise available under the health insurance policy;
(2) allow assignment of a benefit to:
(A) a person who is not legally entitled to receive such a direct payment; or
(B) another person if, under the health insurance policy or plan, the benefit must be provided to the covered person by a physician or other health care provider who is a contractor or preferred provider under the policy; or
(3) prohibit an insurer from verifying, through the insurer's normal process, the health care services the physician or other health care provider provides to the covered person.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.
Sec. 1204.054. PAYMENT OF BENEFITS ACCORDING TO ASSIGNMENT.
An insurer shall pay benefits directly to a physician or other health care provider, and the insurer is relieved of the obligation to pay, and of any liability for paying, those benefits to the covered person if:
(1) the covered person makes a written assignment of those benefits payable to the physician or other health care provider; and
(2) the assignment is obtained by or delivered to the insurer with the claim for benefits.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.
Source: Sec. 1204.053, Sec. 1204.054
