1. (a) An HMO, preferred provider carrier, physician or provider must notify the department if, due to a catastrophic event, it is unable to meet the deadlines in §§21.2804 of this title (relating to Request for Additional Information from Treating Provider), 21.2806 (relating to Claims Filing Deadline), 21.2807 (relating to Effect of Filing a Clean Claim), 21.2808 (relating to Effect of Filing a Deficient Claim), 21.2809 (relating to Audit Procedures), and 21.2815 of this title (relating to Failure to Meet the Statutory Claims Payment Period), as applicable. The entity must send the notification required under this subsection to the department within five days of the catastrophic event.

2. (b) Within ten days after the entity returns to normal business operations, the entity must send a certification of the catastrophic event to the department, to the Life/Health/HMO Filings Intake Division, Texas Department of Insurance, P.O. Box 149104, Mail Code 106-1E. The certification must:

   1. (1) be in the form of a sworn affidavit from:

      1. (A) for a physician or provider, the physician, provider, office manager, administrators or their designees; or
      2. (B) for an HMO or preferred provider carrier, a corporate officer or the corporate officer's designee.
   2. (2) identify the specific nature and date of the catastrophic event; and
   3. (3) identify the length of time the catastrophic event caused an interruption in the claims submission or processing activities of the physician, provider, HMO or preferred provider carrier.
3. (c) A valid certification to the occurrence of a catastrophic event under this section tolls the applicable deadlines in §§21.2804, 21.2806, 21.2807, 21.2808, 21.2809, and 21.2815 of this title for the number of days identified in subsection (b)(3) of this section as of the date of the catastrophic event.

Source Note:The provisions of this §21.2819 adopted to be effective October 5, 2003, 28 TexReg 8647.