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.
Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 2G.004, eff. April 1, 2009.