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.
Tex. Ins. Code § 4201.457
APPEAL DECISIONS
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 4, eff
Official source: Texas Constitution and Statutes. Reproduced from public-domain Texas statutes; confirm against the official source for the current text. Not legal advice.