1. (a) The commissioner shall adopt standards and rules for:

   1. (1) the certification, selection, and operation of independent review organizations to perform independent review described by Subchapter I, Chapter 4201; and
   2. (2) the suspension and revocation of the certification.

2. (b) The standards adopted under this section must ensure:

   1. (1) the timely response of an independent review organization selected under this chapter;
   2. (2) the confidentiality of medical records transmitted to an independent review organization for use in conducting an independent review;
   3. (3) the qualifications and independence of each physician or other health care provider making a review determination for an independent review organization;
   4. (4) the fairness of the procedures used by an independent review organization in making review determinations; and
   5. (5) the timely notice to an enrollee of the results of an independent review, including the clinical basis for the review determination.

Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 4, eff. April 1, 2007.