80th Texas Legislature, Regular Session, House Bill 1003, Chapter 133 Page: 2 of 4
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H.B. No. 1003
1 independent review organization under Chapter 4202 [Art:e:
2 2.58C] , Insurance Code, in the same manner as reviews of
3 utilization review decisions by health maintenance organizations.
4 It is a defense for the insurance carrier if the carrier timely
5 complies with the decision of the independent review organization.
6 (e-2) Notwithstanding Section 4202.002, Insurance Code, an
7 independent review organization that uses doctors to perform
8 reviews of health care services provided under this title may only
9 use doctors licensed to practice in this state.
10 SECTION 3. Sections 1305.355(a) and (d), Insurance Code,
11 are amended to read as follows:
12 (a) The utilization review agent shall:
13 (1) permit the employee or person acting on behalf of
14 the employee and the employee's requesting provider whose
15 reconsideration of an adverse determination is denied to seek
16 review of that determination within the period prescribed by
17 Subsection (b) by an independent review organization assigned in
18 accordance with Chapter 4202 [Article 21.5C] and commissioner
19 rules; and
20 (2) provide to the appropriate independent review
21 organization, not later than the third business day after the date
22 the utilization review agent receives notification of the
23 assignment of the request to an independent review organization:
24 (A) any medical records of the employee that are
25 relevant to the review;
26 (B) any documents used by the utilization review
27 agent in making the determination;
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Texas. Legislature. House of Representatives. 80th Texas Legislature, Regular Session, House Bill 1003, Chapter 133, legislative document, 2007-03/2007-05; [Austin, Texas]. (https://texashistory.unt.edu/ark:/67531/metapth154645/m1/2/: accessed May 21, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.