{"data":{"id":"us-tx/tex.-insurance-code-4201.453","jurisdiction":"us-tx","citation":"Tex. Insurance Code § 4201.453","heading":"UTILIZATION REVIEW PLAN.","body":"A specialty utilization review agent's utilization review plan, including reconsideration and appeal requirements, must be:\n(1) reviewed by a health care provider of the appropriate specialty who is licensed or otherwise authorized to provide the specialty health care service in this state; and\n(2) conducted in accordance with standards developed with input from a health care provider of the appropriate specialty who is licensed or otherwise authorized to provide the specialty health care service in this state.\nAdded by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 4, eff. April 1, 2007.\nAmended by:\nActs 2019, 86th Leg., R.S., Ch. 1218 (S.B. 1742), Sec. 3.07, eff. September 1, 2019.","path":["INSURANCE CODE","TITLE 14. UTILIZATION REVIEW AND INDEPENDENT REVIEW","CHAPTER 4201. UTILIZATION REVIEW AGENTS","SUBCHAPTER J. SPECIALTY UTILIZATION REVIEW AGENTS"],"source_url":"https://statutes.capitol.texas.gov/Docs/IN/htm/IN.4201.htm#4201.453","current_through":"89th 2nd Called Legislative Session, 2025","vintage":"","retrieved_at":"2026-08-27T01:47:21Z","sha256":"e214075f1f5bdca884bf3ad5eacd022ce3a8e3774dbeb4015f4eb6b570011234","source_id":"us-tx","stale":false,"prev":"us-tx/tex.-insurance-code-4201.452","next":"us-tx/tex.-insurance-code-4201.454"},"notice":"GroundRules: Original legal text. Not legal advice."}