Tex. Ins. Code § 4201.456
Current with legislation from the 2023 Regular and Special Sessions signed by the Governor as of November 21, 2023.
Subject to the notice requirements of Subchapter G, before an adverse determination is issued by a specialty utilization review agent who questions the medical necessity, the appropriateness, or the experimental or investigational nature of a health care service, the agent shall provide the health care provider who ordered, requested, or is to provide the service a reasonable opportunity to discuss the patient's treatment plan and the clinical basis for the agent's determination with a health care provider who is of the same specialty as the agent.
Tex. Ins. Code § 4201.456