In this subchapter:
- (1) "Analysis program" means the Health Impact, Cost, and Coverage Analysis Program established under Section 38.452.
- (2) "Center" means the Center for Health Care Data at The University of Texas Health Science Center at Houston.
- (3) "Enrollee" means an individual who is enrolled in a health benefit plan, including a covered dependent.
- (4) "Health benefit plan issuer" means an insurer, health maintenance organization, or other entity authorized to provide health benefits coverage under the laws of this state, including a Medicaid managed care organization. The term does not include an issuer of workers' compensation insurance.
- (5) "Health benefits coverage" does not include workers' compensation.
- (6) "Health care provider" means a physician, facility, or other person who is licensed, certified, registered, or otherwise authorized to provide a health care service in this state.
- (7) "Health care service" means a service, procedure, drug, or device to diagnose, prevent, alleviate, cure, or heal a human disease, injury, or unhealthy or abnormal physical or mental condition, including a service, procedure, drug, or device related to pregnancy or delivery.
(8) "Mandate" means a provision contained in a legislative document that requires a health benefit plan issuer or administrator, with respect to health benefits coverage, to:
- (A) provide coverage for a health care service;
- (B) increase or decrease payments to health care providers for a health care service; or
- (C) implement a new contractual or administrative requirement.
Added by Acts 2025, 89th Leg., R.S., Ch. 689 (H.B. 138), Sec. 1, eff. June 20, 2025.