Texas Statutes
Chapter 4201 - Utilization Review Agents
Subchapter H. Appeal of Adverse Determination

Section 4201.351. Complaint as Appeal - Sec. 4201.351. COMPLAINT AS APPEAL. For purposes of this subchapter,...

Section 4201.352. Written Description of Appeal Procedures - Sec. 4201.352. WRITTEN DESCRIPTION OF APPEAL PROCEDURES. A utilization review...

Section 4201.353. Appeal Procedures Must Be Reasonable - Sec. 4201.353. APPEAL PROCEDURES MUST BE REASONABLE. The procedures for...

Section 4201.354. Persons or Entities Who May Appeal - Sec. 4201.354. PERSONS OR ENTITIES WHO MAY APPEAL. The procedures...

Section 4201.355. Acknowledgment of Appeal - Sec. 4201.355. ACKNOWLEDGMENT OF APPEAL. (a) The procedures for appealing...

Section 4201.356. Decision by Physician Required; Specialty Review - Sec. 4201.356. DECISION BY PHYSICIAN REQUIRED; SPECIALTY REVIEW. (a) The...

Section 4201.357. Expedited Appeal for Denial of Emergency Care, Continued Hospitalization, Prescription Drugs or Intravenous Infusions - Sec. 4201.357. EXPEDITED APPEAL FOR DENIAL OF EMERGENCY CARE, CONTINUED...

Section 4201.358. Response Letter to Interested Persons - Sec. 4201.358. RESPONSE LETTER TO INTERESTED PERSONS. The procedures for...

Section 4201.359. Notice of Appeal - Sec. 4201.359. NOTICE OF APPEAL. (a) The procedures for appealing...

Section 4201.360. Immediate Appeal to Independent Review Organization in Life-Threatening Circumstances - Sec. 4201.360. IMMEDIATE APPEAL TO INDEPENDENT REVIEW ORGANIZATION IN LIFE-THREATENING...

Section 4201.3601. Immediate Appeal to Independent Review Organization for Denial of Prescription Drugs or Intravenous Infusions - Sec. 4201.3601. IMMEDIATE APPEAL TO INDEPENDENT REVIEW ORGANIZATION FOR DENIAL...