Texas § 843.282 SUBMITTING COMPLAINTS TO DEPARTMENT.

Texas Statutes

§ 843.282 — SUBMITTING COMPLAINTS TO DEPARTMENT.

Texas § 843.282

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Bluebook

Tex. Insurance Code Code Ann. § 843.282 (2026).

Text

Sec. 843.282. SUBMITTING COMPLAINTS TO DEPARTMENT.

(a)Any person, including a person who has attempted to resolve a complaint through a health maintenance organization's complaint system process and is dissatisfied with the resolution, may submit a complaint to the department alleging a violation of:

(1)this chapter;

(2)Section 1367.053 ;

(3)Subchapter A , Chapter 1452 ;

(4)Subchapter B , Chapter 1507 ;

(5)Chapters 222 , 251 , and 258 , as applicable to a health maintenance organization; or

(6)Chapter 1271 or 1272 .

(b)The commissioner shall complete an investigation of a complaint against a health maintenance organization to determine whether a violation has occurred not later than the 60th day after the date the department receives the complaint and all information necessary for

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Sec. 843.282. SUBMITTING COMPLAINTS TO DEPARTMENT. (a) Any person, including a person who has attempted to resolve a complaint through a health maintenance organization's complaint system process and is dissatisfied with the resolution, may submit a complaint to the department alleging a violation of:
(1) this chapter;
(2) Section 1367.053 ;
(3) Subchapter A , Chapter 1452 ;
(4) Subchapter B , Chapter 1507 ;
(5) Chapters 222 , 251 , and 258 , as applicable to a health maintenance organization; or
(6) Chapter 1271 or 1272 .
(b) The commissioner shall complete an investigation of a complaint against a health maintenance organization to determine whether a violation has occurred not later than the 60th day after the date the department receives the complaint and all information necessary for the commissioner to make a determination.
(c) The commissioner may extend the time necessary to complete an investigation if:
(1) additional information is needed;
(2) an on-site review is necessary;
(3) the health maintenance organization, the physician or provider, or the complainant does not provide all documentation necessary to complete the investigation; or
(4) other circumstances beyond the control of the department occur.

Legislative History

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003. Amended by: Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636 ), Sec. 2E.047, eff. April 1, 2009.