Text of section effective until April 01, 2025
Sec. 533.002821.  PRIOR AUTHORIZATION PROCEDURES FOR HOSPITALIZED RECIPIENT.  In addition to the requirements of Section 533.005, a contract between a managed care organization and the commission described by that section must require that, notwithstanding any other law, the organization review and issue determinations on prior authorization requests with respect to a recipient who is hospitalized at the time of the request according to the following time frames:
(1)  within one business day after receiving the request, except as provided by Subdivisions (2) and (3);
(2)  within 72 hours after receiving the request if the request is submitted by a provider of acute care inpatient services for services or equipment necessary to discharge the recipient from an inpatient facility; or
(3)  within one hour after receiving the request if the request is related to poststabilization care or a life-threatening condition.
Added by Acts 2019, 86th Leg., R.S., Ch. 619 (S.B. 1096), Sec. 2, eff. September 1, 2019.
Repealed by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 3.01(3), eff. April 1, 2025.