Texas Insurance Code Title 14, Chapter 4202 - Independent Review Organizations

• Texas Section 4202.001 - Definition
  In this chapter, "payor" has the meaning assigned by Section 4201.002. Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 4, eff. April...
• Texas Section 4202.002 - Adoption Of Standards For Independent Review Organizations
  (a) The commissioner shall adopt standards and rules for: (1) the certification, selection, and operation of independent review organizations to perform independent review described by...
• Texas Section 4202.003 - Requirements Regarding Timeliness Of Determination
  The standards adopted under Section 4202.002 must require each independent review organization to make the organization's determination: (1) for a life-threatening condition as defined by...
• Texas Section 4202.004 - Certification
  (a) To be certified as an independent review organization under this chapter, an organization must submit to the commissioner an application in the form required...
• Texas Section 4202.005 - Periodic Reporting Of Information; Biennial Designation; Updates And Inspection
  (a) An independent review organization shall biennially submit the information required in an application for certification under Section 4202.004. Anytime there is a material change...
• Texas Section 4202.006 - Payors Fees
  The commissioner shall charge payors fees in accordance with this chapter as necessary to fund the operations of independent review organizations. Added by Acts 2005,...
• Texas Section 4202.007 - Oversight
  The commissioner shall provide ongoing oversight of the independent review organizations to ensure continued compliance with this chapter and the standards and rules adopted under...
• Texas Section 4202.008 - Prohibited Ownership Or Control Of Independent Review Organization
  An independent review organization may not be a subsidiary of, or in any way owned or controlled by, a payor or a trade or professional...
• Texas Section 4202.009 - Confidential Information
  Information that reveals the identity of a physician or other individual health care provider who makes a review determination for an independent review organization is...
• Texas Section 4202.010 - Immunity From Liability
  (a) An independent review organization conducting an independent review under Subchapter I, Chapter 4201, is not liable for damages arising from the review determination made...
• Texas Section 4202.011 - Advisory Group
  (a) The commissioner shall establish a group to advise the department and make recommendations related to the efficiency of independent review. (b) The commissioner shall...
• Texas Section 4202.012 - Referral
  The commissioner by rule shall require referral by random assignment of adverse determinations under Subchapter I, Chapter 4201, to independent review organizations. On referral of...
• Texas Section 4202.013 - Primary Office In This State Required
  An independent review organization operating under this chapter must maintain the organization's primary office in this state. Added by Acts 2013, 83rd Leg., R.S., Ch....
• Texas Section 4202.014 - Preemption
  The commissioner shall suspend enforcement of any provision of this chapter that the commissioner determines to be preempted by 42 U.S.C. Section 300gg-19. Added by...

Last modified: September 28, 2016