A utilization review agent’s utilization review plan, including reconsideration and appeal requirements, must be reviewed by a physician licensed to practice medicine in this state and conducted in accordance with standards developed with input from appropriate health care providers and approved by a physician licensed to practice medicine in this state.

Added by Acts 2005, 79th Leg., ch. 727, § 4, eff. April 1, 2007. Amended by Acts 2019, 86th Leg., ch. 1218 (S.B. 1742), § 3.02, eff. Sept. 1, 2019.