Texas Insurance Code 1272.060 – Utilization Review
Current as of: 2024 | Check for updates
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A delegation agreement required by Section 1272.052 must provide that:
(1) enrollees shall receive notification at the time of enrollment of which entity is responsible for performing utilization review;
(2) the delegated entity or third party performing utilization review shall perform that review in accordance with Chapter 4201; and
(3) the delegated entity or third party shall forward utilization review decisions made by the entity or third party to the health maintenance organization on a monthly basis.