Texas § 1366.057 PROHIBITED CONDUCT.

Texas Statutes

§ 1366.057 — PROHIBITED CONDUCT.

Texas § 1366.057

Code INInsurance Code

This text of Texas § 1366.057 (PROHIBITED CONDUCT.) is published on Counsel Stack Legal Research, covering Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Tex. Insurance Code Code Ann. § 1366.057 (2026).

Text

Sec. 1366.057. PROHIBITED CONDUCT. An issuer of a health benefit plan may not:

(1)modify the terms and conditions of coverage based on a request by an enrollee for less than the minimum coverage required under Section 1366.055 (a);

(2)offer to a woman who has given birth to a child a financial incentive or other compensation the receipt of which is contingent on the waiver by the woman of the minimum coverage required under Section 1366.055 (a);

(3)refuse to accept a physician's recommendation for inpatient care made in consultation with the woman who has given birth to a child if the period of inpatient care recommended by the physician does not exceed the minimum periods recommended in guidelines for perinatal care developed by:

(A)the American College of Obstetricians and Gynecologi

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Sec. 1366.057. PROHIBITED CONDUCT. An issuer of a health benefit plan may not:
(1) modify the terms and conditions of coverage based on a request by an enrollee for less than the minimum coverage required under Section 1366.055 (a);
(2) offer to a woman who has given birth to a child a financial incentive or other compensation the receipt of which is contingent on the waiver by the woman of the minimum coverage required under Section 1366.055 (a);
(3) refuse to accept a physician's recommendation for inpatient care made in consultation with the woman who has given birth to a child if the period of inpatient care recommended by the physician does not exceed the minimum periods recommended in guidelines for perinatal care developed by:
(A) the American College of Obstetricians and Gynecologists;
(B) the American Academy of Pediatrics; or
(C) another nationally recognized professional association of obstetricians and gynecologists or of pediatricians;
(4) reduce payments or other forms of reimbursement for inpatient care below the usual and customary rate of reimbursement for that care; or
(5) penalize a physician for recommending inpatient care for a woman or the woman's newborn child by:
(A) refusing to permit the physician to participate as a provider in the health benefit plan;
(B) reducing payments made to the physician;
(C) requiring the physician to:
(i) provide additional documentation; or
(ii) undergo additional utilization review; or
(D) imposing other analogous sanctions or disincentives.