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Current as of January 01, 2024 | Updated by FindLaw Staff
(a) This section applies only to a prior authorization request submitted with respect to a recipient who is hospitalized at the time of the request.
(b) In addition to the requirements of Subchapter F, a contract between a Medicaid managed care organization and the commission to which that subchapter applies must require that, notwithstanding any other law, the organization review and issue a determination on a prior authorization request to which this section applies according to the following time frames:
(1) within one business day after the organization receives the request, except as provided by Subdivisions (2) and (3);
(2) within 72 hours after the organization receives the request if a provider of acute care inpatient services submits the request and the request is for services or equipment necessary to discharge the recipient from an inpatient facility; or
(3) within one hour after the organization receives the request if the request is related to poststabilization care or a life-threatening condition. (Gov. Code, Sec. 533.002821.)
Cite this article: FindLaw.com - Texas Government Code - GOV'T § 540.0302. Prior Authorization Procedures for Hospitalized Recipient - last updated January 01, 2024 | https://codes.findlaw.com/tx/government-code/gov-t-sect-540-0302/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature or via Westlaw before relying on it for your legal needs.
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