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Texas Insurance Code - INS § 1272.060. Utilization Review

Current as of January 01, 2024 | Updated by Findlaw Staff

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.

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Cite this article: FindLaw.com - Texas Insurance Code - INS § 1272.060. Utilization Review - last updated January 01, 2024 | https://codes.findlaw.com/tx/insurance-code/ins-sect-1272-060/

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