Texas HB3812 amends preauthorization requirements for health care services and directs utilization review by physicians.
Texas HB3812 amends the Insurance Code to modify preauthorization requirements for certain health care services and the direction of utilization review by physicians. It specifies conditions under which health maintenance organizations or insurers may rescind exemptions from preauthorization requirements. The bill mandates that utilization reviews be conducted under the direction of a licensed physician and outlines procedures for physicians and providers to appeal and seek independent reviews of adverse determinations.
Included in complete analysis
- Overview
- Core Provisions
- Implementation
- Impact
- Legal Framework
- Critical Issues
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