Physician and provider contracts and arrangements shall include the following provisions:

1. (1) regarding hold harmless clause as described in the Insurance Code Article 20A.18A(g) and §11.1102 of this title (relating to Hold Harmless Clause);
2. (2) regarding retaliation as described in the Insurance Code Article 20A.14(k);
3. (3) regarding continuity of treatment, if applicable, as described in the Insurance Code Article 20A.18(A)(c);
4. (4) regarding written notification of termination to a physician or provider at least 90 days prior to the effective date of the termination of the physician or provider, except in the case of imminent harm to patient health, action against license to practice, or fraud pursuant to Insurance Code Article 20A.18A(b), in which case termination may be immediate. Upon written notification of termination, a physician or provider may seek review of the termination within a period not to exceed 60 days, pursuant to the procedure set forth in the Insurance Code Article 20A.18A(b). The HMO must provide notification of the termination of a physician or provider to its enrollees receiving care from the provider being terminated at least 30 days before the effective date of the termination. Notification of termination of a physician or provider to enrollees for reasons related to imminent harm may be given to enrollees immediately;
5. (5) regarding posting of complaints notice in physician/provider offices as described in the Insurance Code Article 20A.18A(i). A representative notice that complies with this requirement may be obtained from the Texas Department of Insurance, HMO/UR/QA Group, P.O. Box 149104, Austin, Texas 78714-9104;
6. (6) regarding indemnification of the HMO as described in the Insurance Code Article 20A.18A(f);
7. (7) regarding prompt payment of claims as described in the Insurance Code Article 20A.09(j);
8. (8) regarding capitation, if applicable, as described in the Insurance Code Article 20A.18A(e); and
9. (9) regarding selection of a primary physician or provider, if applicable, as described in the Insurance Code Article 20A.18A(e).

Source Note:The provisions of this §11.901 adopted to be effective November 2, 1998, 23 TexReg 11347.