1. (a) The department shall randomly assign each request for independent review to an independent review organization and shall notify the utilization review agent and the health insurance carrier, health maintenance organization, managed care entity, or other payor requesting the independent review, the independent review organization, the patient or a representative of the patient, and the provider of record of such assignment.
2. (b) The department shall screen payors and utilization review agents for potential conflicts of interest with the independent review organization before making an assignment to the independent review organization. The independent review organization shall screen its physicians and other providers conducting independent review for potential conflicts of interest. The department shall have the discretion to determine whether conflicts exist.
3. (c) Independent review organizations shall be added to the list from which random assignments for independent review are made in order of the date of issuance of the certificate of registration by the department.
4. (d) Random assignment shall be made chronologically from the list of independent review organizations with ultimate assignment to the first in line with no apparent conflicts of interest.
5. (e) Assignment of an independent review to an independent review organization moves the independent review organization receiving the assignment to the bottom of the assignment list.

6. (f) Independent reviews will not be assigned:

   1. (1) to an independent review organization during the 30 days prior to the anniversary date of the issuance of the independent review organization's certificate of registration unless the completed application for renewal of its certificate of registration and the application fee have been received by the department; or
   2. (2) during the time that an independent review organization has surrendered its certificate of registration pursuant to §12.303 of this chapter (relating to Surrender of Certificate of Registration) and the Insurance Code §4202.002(c)(2)(B).
7. (g) Nonselection for presence of conflicts of interest does not move the independent review organization to the bottom of the assignment list. Such independent review organization retains its chronological position until selected for independent review.

Source Note:The provisions of this §12.502 adopted to be effective November 26, 1997, 22 TexReg 11363; amended to be effective December 26, 2010, 35 TexReg 11281.