- (a) Statutory basis. This subchapter implements the provisions of the Insurance Code Article 21.58A, which was amended by H.B. 3197 in 1997, 75th Legislature, Chapter 903 which was effective September 1, 1997, but applies only to utilization reviews for medical benefits provided under workers' compensation insurance coverage conducted on or after January 1, 1998.
- (b) Severability. Where any terms or sections of this subchapter are determined by a court of competent jurisdiction to be inconsistent with any statutes of this state, or to be unconstitutional, the remaining terms and provisions of this subchapter shall remain in effect.
(c) Purpose. The purpose of these rules is to:
- (1) promote the delivery of quality health care in a cost-effective manner, including protection of injured employee safety;
- (2) assure that utilization review agents adhere to reasonable standards for conducting utilization reviews;
- (3) foster greater coordination and cooperation between health care providers and utilization review agents;
- (4) improve communications and knowledge of medical benefits among all parties; and
- (5) ensure that utilization review agents maintain the confidentiality of medical records in accordance with applicable law.
Source Note:The provisions of this §19.2001 adopted to be effective September 20, 1998, 23 TexReg 9560.