(a) The department will randomly assign each request for independent review to an IRO and will notify the utilization review agent and the health insurance carrier, health maintenance organization, managed care entity, or other payor requesting the independent review, the IRO, the patient or a representative of the patient, and the provider of record of the assignment.
(b) The department will screen payors and utilization review agents for potential conflicts of interest with the IRO before making an assignment to the IRO. The IRO must screen its physicians and other providers conducting independent review for potential conflicts of interest. The department has the discretion to determine whether conflicts exist.
(c) IROs will be added to the list from which random assignments for independent reviews are made in order of the date of issuance of the certificate of registration by the department.
(d) The department will randomly assign IROs chronologically from the list of IROs, with ultimate assignment to the first in line with no apparent conflicts of interest.
(e) Assignment of an independent review to an IRO moves the IRO receiving the assignment to the bottom of the assignment list.
(f) Independent reviews will not be assigned:
  (1) to an IRO during the 30 days before the anniversary date of the issuance of the IRO's certificate of registration unless the completed application for renewal of its certificate of registration and the application fee have been received by the department; or
  (2) during the time that an IRO has surrendered its certificate of registration under §12.303 of this chapter and Insurance Code §4202.002(c)(2)(B).
(g) Nonselection for presence of conflicts of interest does not move the IRO to the bottom of the assignment list. The IRO retains its chronological position until selected for independent review.

Source Note: The provisions of this §12.502 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