Sec. 1453.001. DEFINITIONS. In this chapter: (1) "Health care provider" means: (A) a hospital, emergency clinic, outpatient clinic, or other facility providing health care services; or (B) an individual who is licensed in this state to provide health care services. (2) "Managed care entity" means: (A) a health maintenance organization; (B) a preferred provider benefit plan issuer; (C) an approved nonprofit health corporation that holds a certificate of authority under Chapter 844 ; or (D) another entity that offers a managed care plan, including: (i) an insurance company; (ii) a group hospital service corporation operating under Chapter 842 ; (iii) a fraternal benefit society operating under Chapter 885 ; (iv) a stipulated premium company operating under Chapter 884 ; (v) a multiple employer welfare arrangement that holds a certificate of authority under Chapter 846 ; and (vi) an entity not authorized under this code or another insurance law of this state that contracts directly for health care services on a risk-sharing basis, including a capitation basis. (3) "Managed care plan" means a health benefit plan: (A) under which health care services are provided through contracts with health care providers to individuals enrolled in or insured under the plan; and (B) that provides financial incentives to individuals enrolled in or insured under the plan to use health care providers participating in the plan and procedures covered by the plan.
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