Tex. Ins. Code § 4201.402 · Subchapter I. INDEPENDENT REVIEW OF ADVERSE DETERMINATION
INFORMATION PROVIDED TO INDEPENDENT REVIEW ORGANIZATION.
Text — Current through the 89th 2nd Called Legislative Session, 2025
(a) Not later than the third business day after the date a utilization review agent receives a request for independent review, the agent shall provide to the appropriate independent review organization:
(1) a copy of:
(A) any medical records of the enrollee that are relevant to the review;
(B) any documents used by the plan in making the determination to be reviewed;
(C) the written notification described by Section 4201.359; and
(D) any documents and other written information submitted to the agent in support of the appeal; and
(2) a list of each physician or other health care provider who:
(A) has provided care to the enrollee; and
(B) may have medical records relevant to the appeal.
(b) A utilization review agent may provide confidential information in the custody of the agent to an independent review organization, subject to rules and standards adopted by the commissioner under Chapter 4202.
Notes and commentary — not statutory text
History
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 4, eff. April 1, 2007.
Source of truth
- Edition
- Current through the 89th 2nd Called Legislative Session, 2025
- Official file
- https://statutes.capitol.texas.gov/Docs/IN/htm/IN.4201.htm
- Text hash
- sha256 02bfcb6a6fe6de8d19cab7d45f134bf99a73815dcb78c93a5b3621171b86c768
- 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.
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.