Texas Cancellation of HMO Certificate of Authority is a document issued by the Texas Department of Insurance (TDI) that terminates the Certificate of Authority of a health maintenance organization (HMO) in the state of Texas. The cancellation of the HMO Certificate of Authority is required when a HMO decides to no longer offer or provide health care services in Texas. The Texas Cancellation of HMO Certificate of Authority process includes the submission of a formal request to the TDI, along with supporting documents such as financial statements, legal documents, and documents related to the HMO's operational activities. There are two types of Texas Cancellation of HMO Certificate of Authority: voluntary and involuntary. Voluntary cancellation is initiated by the HMO itself, while involuntary cancellation is initiated by the TDI due to non-compliance with regulations or other legal requirements. Both types of cancellation require the submission of the appropriate documents to the TDI.
Texas Cancellation of HMO Certificate of Authority
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FAQ
The US Health Care Financing Administration (HCFA) regulates HMOs and has instituted guidelines for reporting and quality assessment in an accreditation approach to quality assurance (see Chapter 15).
Chapter 843 - HEALTH MAINTENANCE ORGANIZATIONS.
Texas law requires HMOs to have adequate personnel and facilities to meet their members' needs. HMOs also must make health care services available within a certain distance of your home and workplace.
Insurance companies violate the Texas Unfair Claims Practices Act when they: Knowingly misrepresent material facts or policy provisions related to coverage. Fail to attempt in good faith to effectuate a prompt, fair and equitable settlement of a claim with respect to which their liability has become reasonably clear.
But for a bad faith claim, under Texas law, you will only have two years to file suit. The two-year limit begins from: The date the unfair method of competition or unfair or deceptive act or practice occurred.
The Texas Insurance Code is the part of Texas state law that governs the way that insurance companies can operate in the state.
Statutory Bad Faith Statutory violations allow a person to hold an insurer liable for damages caused by unreasonable delays in responding to and paying claims and misrepresentations regarding the policy, the claim, or coverage.