{"data":{"id":"us-tx/tex.-insurance-code-4201.457","jurisdiction":"us-tx","citation":"Tex. Insurance Code § 4201.457","heading":"APPEAL DECISIONS.","body":"A specialty utilization review agent shall comply with the requirement that a physician or other health care provider who makes the decision in an appeal of an adverse determination must be of the same or a similar specialty as the health care provider who would typically manage the specialty condition, procedure, or treatment under review in the appeal.\nAdded by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 4, eff. April 1, 2007.","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#4201.457","current_through":"89th 2nd Called Legislative Session, 2025","vintage":"","retrieved_at":"2026-08-27T01:47:21Z","sha256":"3a4641326cfaeba6447a8db0a209d878f7bafe8a9d2259857c45c9d700980e0e","source_id":"us-tx","stale":false,"prev":"us-tx/tex.-insurance-code-4201.456","next":"us-tx/tex.-insurance-code-4201.551"},"notice":"GroundRules: Original legal text. Not legal advice."}