Texas § IN.1551.015 - BALANCE BILLING PROHIBITION NOTICE
Full text of Texas The Texas Constitution § IN.1551.015 — BALANCE BILLING PROHIBITION NOTICE, with citation guidance and answers to common questions.
§ IN.1551.015. BALANCE BILLING PROHIBITION NOTICE
BALANCE BILLING PROHIBITION NOTICE. (a) The administrator of a managed care plan provided under the group benefits program shall provide written notice in accordance with this section in an explanation of benefits provided to the participant and the physician or health care provider in connection with a health care or medical service or supply provided by an out-of-network provider. The notice must include: (1) a statement of the billing prohibition under Section 1551.228 , 1551.229 , or 1551.230 , as applicable; (2) the total amount the physician or provider may bill the participant under the participant's managed care plan and an itemization of copayments, coinsurance, deductibles, and other amounts included in that total; and (3) for an explanation of benefits provided to the physician or provider, information required by commissioner rule advising the physician or provider of the availability of mediation or arbitration, as applicable, under Chapter 1467 . (b) The administrator shall provide the explanation of benefits with the notice required by this section to a physician or health care provider not later than the date the administrator makes a payment under Section 1551.228 , 1551.229 , or 1551.230 , as applicable. Added by Acts 2019, 86th Leg., R.S., Ch. 1342 (S.B. 1264 ), Sec. 1.11, eff. September 1, 2019. Amended by: Acts 2023, 88th Leg., R.S., Ch. 981 (S.B. 2476 ), Sec. 9(a), eff. September 1, 2023. Acts 2023, 88th Leg., R.S., Ch. 981 (S.B. 2476 ), Sec. 9(b), eff. September 1, 2025. SUBCHAPTER B. ADMINISTRATION AND IMPLEMENTATION
Source: official Texas text · Last verified 2026-08-27
Frequently Asked Questions About Texas § IN.1551.015
What does The Texas Constitution § IN.1551.015 cover?
Section IN.1551.015 ("BALANCE BILLING PROHIBITION NOTICE") is part of the The Texas Constitution, the codified statutory law of Texas. It sets out the legal rule or procedure described in the text above. Statutes are amended regularly, so always verify against the official source.
How do I cite Texas § IN.1551.015?
A common citation format is "The Texas Constitution § IN.1551.015" (Texas). Legal writing may require the code abbreviation, section number, and year or edition. Match the style required by your court, professor, or publisher.
Is this the official text of Texas law?
No. This page is for research and education and may not include the most recent amendments. For official current law, check the Texas official source linked on this page or consult a licensed Texas attorney.
How does Texas § IN.1551.015 apply to my situation?
Statutes are interpreted in context, and application depends on your specific facts. Only a licensed attorney in Texas can advise on how this section applies to you. Contact your state or local bar association for a referral.
Sources & Verification
Not legal advice. Verify against the official source and consult a licensed attorney in Texas.