Tex. Gov't Code § 540.0307 · Subchapter G. PRIOR AUTHORIZATION AND UTILIZATION REVIEW PROCEDURES
MAXIMUM PERIOD FOR PRIOR AUTHORIZATION DECISION; ACCESS TO CARE.
Text — Current through the 89th 2nd Called Legislative Session, 2025
The combined amount of time provided for the time frames prescribed by the utilization review and prior authorization procedures described by Sections 540.0301, 540.0303, and 540.0305 and the timeline for reconsidering an adverse determination on a prior authorization described by Section 540.0306 may not exceed the time frame for a decision under federally prescribed time frames. It is the intent of the legislature that these provisions allow sufficient time to provide necessary documentation and avoid unnecessary denials without delaying access to care.
Notes and commentary — not statutory text
History
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
Source of truth
- Edition
- Current through the 89th 2nd Called Legislative Session, 2025
- Official file
- https://statutes.capitol.texas.gov/Docs/GV/htm/GV.540.htm
- Text hash
- sha256 bc09837c23e6d37b2749b03adea87b2110befabd9fa48fef44aff5855c9e5f3a
- Composed by
- compose_tx.py 2026-10-05: the Legislative Council's chapter files read in document order; verify_tx.py's independent reading (lxml DOM walk) agrees character for character
This section cites
Provisions in this library that the text above cites, as it prints each citation. A range cited as “ss. 61.13-61.16” links its first and last provisions.
Government Code
- Tex. Gov't Code § 540.0301INAPPLICABILITY OF CERTAIN OTHER LAW TO MEDICAID MANAGED CARE UTILIZATION REVIEWS.Printed as Sections 540.0301, 540.0303, and 540.0305
- Tex. Gov't Code § 540.0303PRIOR AUTHORIZATION PROCEDURES FOR NONHOSPITALIZED RECIPIENT.Printed as Sections 540.0301, 540.0303, and 540.0305
- Tex. Gov't Code § 540.0305PHYSICIAN CONSULTATION BEFORE ADVERSE PRIOR AUTHORIZATION DETERMINATION.Printed as Sections 540.0301, 540.0303, and 540.0305
- Tex. Gov't Code § 540.0306RECONSIDERATION FOLLOWING ADVERSE DETERMINATIONS ON CERTAIN PRIOR AUTHORIZATION REQUESTS.Printed as Section 540.0306
Procedural information only. Not legal advice and not a substitute for the advice of an attorney. Confirm the current text with the official publisher before relying on it.