28 Tex. Admin. Code § 134.806 - Records Excluded from Reporting
(a)
Insurance carriers shall not report medical EDI records for health care
services:
(1) rendered outside the United
States;
(2) related to dates of
injury before January 1, 1991;
(3)
rendered at a Federal health care facility and the health care facility does
not provide the insurance carrier with the data required to be
reported;
(4) related to an injured
employee's travel reimbursement as provided in §
134.110 of this title (relating to
Reimbursement of Injured Employee for Travel Expenses Incurred); or
(5) related to a request for reimbursement by
a health care insurer in accordance with the provisions of Labor Code §
409.0091.
(b) Insurance carriers shall not
report interest and penalty payments paid on health care services, medical cost
containment expenses, medical bill review expenses or data transmission
expenses in medical EDI records.
(c) This section is effective September 1,
2011.
Notes
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