Texas § 408.0272 CERTAIN EXCEPTIONS FOR UNTIMELY SUBMISSION OF CLAIM.

Texas Statutes

§ 408.0272 — CERTAIN EXCEPTIONS FOR UNTIMELY SUBMISSION OF CLAIM.

Texas § 408.0272

Code LALabor Code

This text of Texas § 408.0272 (CERTAIN EXCEPTIONS FOR UNTIMELY SUBMISSION OF CLAIM.) 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. Labor Code Code Ann. § 408.0272 (2026).

Text

Sec. 408.0272. CERTAIN EXCEPTIONS FOR UNTIMELY SUBMISSION OF CLAIM.

(a)In this section:

(1)"Group accident and health insurance" has the meaning assigned by Chapter 1251 , Insurance Code.

(2)"Health maintenance organization" has the meaning assigned by Chapter 843 , Insurance Code.

(b)Notwithstanding Section 408.027 , a health care provider who fails to timely submit a claim for payment to the insurance carrier under Section 408.027 (a) does not forfeit the provider's right to reimbursement for that claim for payment solely for failure to submit a timely claim if:

(1)the provider submits proof satisfactory to the commissioner that the provider, within the period prescribed by Section 408.027 (a), erroneously filed for reimbursement with:

(A)an insurer that issues a policy of group ac

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Sec. 408.0272. CERTAIN EXCEPTIONS FOR UNTIMELY SUBMISSION OF CLAIM. (a) In this section:
(1) "Group accident and health insurance" has the meaning assigned by Chapter 1251 , Insurance Code.
(2) "Health maintenance organization" has the meaning assigned by Chapter 843 , Insurance Code.
(b) Notwithstanding Section 408.027 , a health care provider who fails to timely submit a claim for payment to the insurance carrier under Section 408.027 (a) does not forfeit the provider's right to reimbursement for that claim for payment solely for failure to submit a timely claim if:
(1) the provider submits proof satisfactory to the commissioner that the provider, within the period prescribed by Section 408.027 (a), erroneously filed for reimbursement with:
(A) an insurer that issues a policy of group accident and health insurance under which the injured employee is a covered insured;
(B) a health maintenance organization that issues an evidence of coverage under which the injured employee is a covered enrollee; or
(C) a workers' compensation insurance carrier other than the insurance carrier liable for the payment of benefits under this title; or
(2) the commissioner determines that the failure resulted from a catastrophic event that substantially interfered with the normal business operations of the provider.
(c) Notwithstanding Subsection (b), a health care provider who erroneously submits a claim for payment to an entity described by Subdivision (1) of that subsection forfeits the provider's right to reimbursement for that claim if the provider fails to submit the claim to the correct workers' compensation insurance carrier within 95 days after the date the provider is notified of the provider's erroneous submission of the claim.
(d) Notwithstanding any other provision of this section or Section 408.027 , the period for submitting a claim for payment may be extended by agreement of the parties.