Code: 

Insurance Code

Title: 

Title 14. Utilization Review and Independent Review

Section: 

4201.457

Name: 

Appeal Decisions

Eff. Date: 

April 1, 2007
§4201.457
Appeal Decisions

A specialty utilization review agent shall comply with the requirement that a physician or other health care provider who makes the decision in an appeal of an adverse determination must be of the same or a similar specialty as the health care provider who would typically manage the specialty condition, procedure, or treatment under review in the appeal.

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