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WebIt is this inclusion of services intended to maintain a member's health that gave the HMO its name. Some services, such as outpatient mental health care, are limited, and more costly forms of care, diagnosis, or treatment may not be covered. WebNov 18, 2024 · Under §TIC 843.281 and 28 TAC §11.901 (2), an HMO is prohibited from engaging in retaliatory action against a group contract holder, an enrollee, a person acting on behalf of a group contract holder or enrollee, or a physician/provider for filing a complaint against the HMO or for appealing a decision of the HMO. Q. What is an Access plan? A. WebCoverage. Significance. A health maintenance organization (HMO) is a type of health insurance that employs or contracts with a network of physicians or medical groups to … overflow aspx