Sec. 4201.3601. IMMEDIATE APPEAL TO INDEPENDENT REVIEW ORGANIZATION FOR DENIAL OF PRESCRIPTION DRUGS OR INTRAVENOUS INFUSIONS. Notwithstanding any other law, in a circumstance involving the provision of prescription drugs or intravenous infusions for which the patient is receiving benefits under the health insurance policy, the enrollee is:
(1) entitled to an immediate appeal to an independent review organization as provided by Subchapter I; and
(2) not required to comply with procedures for an internal review of the utilization review agent's adverse determination.
Added by Acts 2015, 84th Leg., R.S., Ch. 1037 (H.B. 1621), Sec. 7, eff. September 1, 2015.
Structure Texas Statutes
Title 14 - Utilization Review and Independent Review
Chapter 4201 - Utilization Review Agents
Subchapter H. Appeal of Adverse Determination
Section 4201.351. Complaint as Appeal
Section 4201.352. Written Description of Appeal Procedures
Section 4201.353. Appeal Procedures Must Be Reasonable
Section 4201.354. Persons or Entities Who May Appeal
Section 4201.355. Acknowledgment of Appeal
Section 4201.356. Decision by Physician Required; Specialty Review
Section 4201.358. Response Letter to Interested Persons