(a) The commissioner may conduct an on-site examination at the applicant's primary office as a requirement of applying for a certificate of registration.
(b) The commissioner may conduct examinations of an IRO as often as the commissioner deems necessary to determine compliance with Insurance Code Chapter 4202 and this chapter, including on renewal of the certificate of registration.
(c) The following documents must be available for review during an examination at the primary office of the IRO located within this state:
  (1) the information required in §12.103 of this chapter;
  (2) credentialing files;
  (3) case decisions files;
  (4) a list of personnel who are available at the IRO's primary office 40 hours a week during normal business hours in both Central and Mountain time zones;
  (5) a list of directors, officers, and executives and owners or shareholders, or if the IRO is publicly held, owners or shareholders of more than 5 percent of any of the IRO's stock or options as described by Insurance Code §4202.004(a)(1);
  (6) a chart showing the internal organizational structure of the IRO management and administrative staff;
  (7) a chart showing the contractual relationships and arrangements of the IRO, as described in §12.103 of this chapter; and
  (8) any other documents related to the operation of the IRO.
(d) The owner and IRO staff, including the CEO, medical director, and operations staff, must be available at the IRO's primary office during the on-site examination to answer all questions regarding the IRO's operations, produce documents, and demonstrate to the examiner the operations of the IRO.

Source Note: The provisions of this §12.106 adopted to be effective November 26, 1997, 22 TexReg 11363; amended to be effective December 26, 2010, 35 TexReg 11281; amended to be effective July 7, 2015, 40 TexReg 2538