Texas Insurance Code 4201.3601 – Immediate Appeal to Independent Review Organization for Denial of Prescription Drugs or Intravenous Infusions
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Terms Used In Texas Insurance Code 4201.3601
- Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
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.