Texas · Through 89th 2nd Called Legislative Session, 2025

Tex. Government Code § 540.0307: MAXIMUM PERIOD FOR PRIOR AUTHORIZATION DECISION; ACCESS TO CARE.

Where this section sits in the code

GOVERNMENT CODE
TITLE 4. EXECUTIVE BRANCH
SUBTITLE I. HEALTH AND HUMAN SERVICES
CHAPTER 540. MEDICAID MANAGED CARE PROGRAM
SUBCHAPTER G. PRIOR AUTHORIZATION AND UTILIZATION REVIEW PROCEDURES

The combined amount of time provided for the time frames prescribed by the utilization review and prior authorization procedures described by Sections 540.0301, 540.0303, and 540.0305 and the timeline for reconsidering an adverse determination on a prior authorization described by Section 540.0306 may not exceed the time frame for a decision under federally prescribed time frames. It is the intent of the legislature that these provisions allow sufficient time to provide necessary documentation and avoid unnecessary denials without delaying access to care.

Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.

Collected 2026-08-27T01:47:16Z. Source file · JSON

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