The amendments to §§21.2801-21.2803, 21.2807-21.2809 and 21.2811-21.2817 of this title (relating to Scope, Definitions, Elements of a Clean Claim, Effect of Filing a Clean Claim, Effect of Filing Deficient Claim, Audit Procedures, Disclosure of Processing Procedures, Denial of Clean Claim Prohibited for Change of Address, Requirements Applicable to Other Contracting Entities, Electronic Adjudication of Prescription Benefits. Failure to Meet the Statutory Claims Payment Period, Date of Receipt, and Terms of Contracts), and new §§21.2804-21.2806, §§21.2818, 21.2819 and 21.2821-21.2825 of this title (relating to Requests for Additional Information from Treating Preferred Provider, Requests for Additional Information from Other Sources, Claims Filing Deadline, Overpayment of Claims, Catastrophic Event, Reporting Requirements, Administrative Penalties, Applicability to Certain Non-Contracting Physicians and Providers, Applicability, and Severability) apply to services provided, or inpatient services beginning, pursuant to contracts entered into or renewed between an HMO or preferred provider carrier and a preferred provider on or after October 5, 2003 and to services provided or hospital confinements beginning on or after October 5, 2003, by physicians and providers that do not have a contract with an HMO or preferred provider carrier.

Source Note:The provisions of this §21.2824 adopted to be effective October 5, 2003, 28 TexReg 8647.