Sec. 1461.001. DEFINITIONS. In this chapter: (1) "Enrollee" means an individual who is eligible to receive health care services under a managed care plan. (2) "Maintenance of certification" has the meaning assigned by Section 151.002 , Occupations Code. (3) "Managed care plan" means a health benefit plan under which health care services are provided to enrollees through contracts with physicians and that requires enrollees to use participating physicians or that provides a different level of coverage for enrollees who use participating physicians. The term includes a health benefit plan issued by: (A) a health maintenance organization; (B) a preferred provider benefit plan issuer; or (C) any other entity that issues a health benefit plan, including an insurance company. (4) "Participating physician" means a physician who has directly or indirectly contracted with a health benefit plan issuer to provide services to enrollees. (5) "Physician" means an individual licensed to practice medicine in this state.
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