(a) Insurance carriers shall not report medical EDI records for health care services:
- (1) rendered outside the United States;
- (2) related to dates of injury before January 1, 1991;
- (3) rendered at a Federal health care facility and the health care facility does not provide the insurance carrier with the data required to be reported;
- (4) related to an injured employee's travel reimbursement as provided in §134.110 of this title (relating to Reimbursement of Injured Employee for Travel Expenses Incurred); or
- (5) related to a request for reimbursement by a health care insurer in accordance with the provisions of Labor Code §409.0091.
- (b) Insurance carriers shall not report interest and penalty payments paid on health care services, medical cost containment expenses, medical bill review expenses or data transmission expenses in medical EDI records.
- (c) This section is effective September 1, 2011.
Source Note:The provisions of this §134.806 adopted to be effective September 1, 2011, 36 TexReg 4136.