{"data":{"id":"us-tx/tex.-government-code-532.0401","jurisdiction":"us-tx","citation":"Tex. Government Code § 532.0401","heading":"REVIEW OF PRIOR AUTHORIZATION AND UTILIZATION REVIEW PROCESSES.","body":"The commission shall:\n(1) in accordance with an established schedule, periodically review the prior authorization and utilization review processes within the Medicaid fee-for-service delivery model to determine whether those processes need modification to reduce authorizations of unnecessary services and inappropriate use of services;\n(2) monitor the prior authorization and utilization review processes within the Medicaid fee-for-service delivery model for anomalies and, on identification of an anomaly in a process, review the process for modification earlier than scheduled; and\n(3) monitor Medicaid managed care organizations to ensure that the organizations are using prior authorization and utilization review processes to reduce authorizations of unnecessary services and inappropriate use of services.\nAdded by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.","path":["GOVERNMENT CODE","TITLE 4. EXECUTIVE BRANCH","SUBTITLE I. HEALTH AND HUMAN SERVICES","CHAPTER 532. MEDICAID ADMINISTRATION AND OPERATION IN GENERAL","SUBCHAPTER I. UTILIZATION REVIEW, PRIOR AUTHORIZATION, AND COVERAGE PROCESSES AND DETERMINATIONS"],"source_url":"https://statutes.capitol.texas.gov/Docs/GV/htm/GV.532.htm#532.0401","current_through":"89th 2nd Called Legislative Session, 2025","vintage":"","retrieved_at":"2026-08-27T01:47:16Z","sha256":"52405ec5f0b5a4a1d590f681c5904945a34ccacc1e0e5487056c12ed84b85e90","source_id":"us-tx","stale":false,"prev":"us-tx/tex.-government-code-532.0353","next":"us-tx/tex.-government-code-532.0402"},"notice":"GroundRules: Original legal text. Not legal advice."}