| (a) The purpose of this subchapter is to interpret
and implement Insurance Code §§1271.157, 1271.158, 1275.052,
1275.053, 1301.164, 1301.165, 1551.229, 1551.230, 1575.172, 1575.173,
1579.110, and 1579.111; and Insurance Code Chapter 1467.
(b) Section 21.4903 of this title is only applicable
to a covered nonemergency health care or medical service or supply
provided by:
(1) a facility-based provider that is not a participating
provider for a health benefit plan, if the service or supply is provided
at a health care facility that is a participating provider; or
(2) a diagnostic imaging provider or laboratory service
provider that is not a participating provider for a health benefit
plan, if the service or supply is provided in connection with a health
care or medical service or supply provided by a participating provider.
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