Sec. 1272.060.  UTILIZATION REVIEW.  A delegation agreement required by Section 1272.052 must provide that:
(1)  enrollees shall receive notification at the time of enrollment of which entity is responsible for performing utilization review;
(2)  the delegated entity or third party performing utilization review shall perform that review in accordance with Chapter 4201; and
(3)  the delegated entity or third party shall forward utilization review decisions made by the entity or third party to the health maintenance organization on a monthly basis.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.
Amended by: 
Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 2G.004, eff. April 1, 2009.