Sec. 4201.151. UTILIZATION REVIEW PLAN. A utilization review agent's utilization review plan, including reconsideration and appeal requirements, must be reviewed by a physician licensed to practice medicine in this state and conducted in accordance with standards developed with input from appropriate health care providers and approved by a physician licensed to practice medicine in this state.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 4, eff. April 1, 2007.
Amended by:
Acts 2019, 86th Leg., R.S., Ch. 1218 (S.B. 1742), Sec. 3.02, eff. September 1, 2019.
Structure Texas Statutes
Title 14 - Utilization Review and Independent Review
Chapter 4201 - Utilization Review Agents
Subchapter D. Utilization Review: General Standards
Section 4201.151. Utilization Review Plan
Section 4201.152. Utilization Review Under Physician
Section 4201.153. Screening Criteria and Review Procedures
Section 4201.154. Review and Inspection of Screening Criteria and Review Procedures
Section 4201.155. Limitation on Notice Requirements and Review Procedures