(a) Except as provided by this section, this chapter applies to utilization review of a health care service provided to a person eligible for workers’ compensation medical benefits under Title 5, Labor Code. The commissioner of workers’ compensation shall regulate as provided by this chapter a person who performs utilization review of a medical benefit provided under Title 5, Labor Code.
(b) Sections 4201.303(c), 4201.304(b), 4201.357(a-1), and 4201.3601 do not apply to utilization review of a health care service provided to a person eligible for workers’ compensation benefits under Title 5, Labor Code.

Terms Used In Texas Insurance Code 4201.054

  • Person: includes corporation, organization, government or governmental subdivision or agency, business trust, estate, trust, partnership, association, and any other legal entity. See Texas Government Code 311.005

(c) Title 5, Labor Code, prevails in the event of a conflict between this chapter and Title 5, Labor Code.
(d) The commissioner of workers’ compensation may adopt rules as necessary to implement this section.

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