Section 533.002821 - [Repealed Effective 4/1/2025] Prior Authorization Procedures for Hospitalized Recipient In addition to the requirements of Section 533.005, a contract between a managed care organization and the commission described by that section must require that, notwithstanding any other law, the organization review and issue determinations on prior authorization requests with respect to a recipient who is hospitalized at the time of the request according to the following time frames:
(1) within one business day after receiving the request, except as provided by Subdivisions (2) and (3);(2) within 72 hours after receiving the request if the request is submitted by a provider of acute care inpatient services for services or equipment necessary to discharge the recipient from an inpatient facility; or(3) within one hour after receiving the request if the request is related to poststabilization care or a life-threatening condition.Tex. Gov't. Code § 533.002821
Repealed by Acts 2023, Texas Acts of the 88th Leg.- Regular Session, ch. 769,Sec. 3.01, eff. 4/1/2025.Added by Acts 2019, Texas Acts of the 86th Leg.- Regular Session, ch. 619,Sec. 2, eff. 9/1/2019.