Texas Life & Health · Outline section
State specific IV: Texas statutes and rules pertinent to HMOs
3 scored items on the September 2026 official outline. A small section that still costs retakers points. Texas defines HMO emergency care by a prudent-layperson standard, not by later utilization review.
Official locator: Pearson VUE Texas Insurance Supplement, printed page S7, State Specific Section IV
Statutes to keep open
- Texas Insurance Code Chapter 843
§843.002 — emergency care / prudent layperson
Common mistakes to avoid
- Letting the HMO medical director’s after-the-fact review set the emergency standard.
- Requiring a primary-care referral before emergency care is “real.”
- Confusing the treating physician’s bill with the statutory definition.
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