The procedures for appealing an adverse determination must provide that, after the utilization review agent has sought review of the appeal, the agent shall issue a response letter explaining the resolution of the appeal to:

(1) the patient or a person acting on the patient’s behalf; and

(2) the patient’s physician or other health care provider.

Added by Acts 2005, 79th Leg., ch. 727, § 4, eff. April 1, 2007.