Code: 

Insurance Code

Title: 

Title 14. Utilization Review and Independent Review

Section: 

4201.3601

Name: 

Immediate Appeal to Independent Review Organization for Denial of Prescription Drugs or Intravenous Infusions

Eff. Date: 

September 1, 2015

No Rule Reference

§4201.3601
Immediate Appeal to Independent Review Organization for Denial of Prescription Drugs or Intravenous Infusions

Notwithstanding any other law, in a circumstance involving the provision of prescription drugs or intravenous infusions for which the patient is receiving benefits under the health insurance policy, the enrollee is:

(1) entitled to an immediate appeal to an independent review organization as provided by Subchapter I; and

(2) not required to comply with procedures for an internal review of the utilization review agent’s adverse determination.

Added by Acts 2015, 84th Leg., ch. 1037 (H.B. 1621), § 7, eff. Sept. 1, 2015.