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Tex. Gov’t Code § 531.024162. Notice Requirements Regarding Denial of Coverage or Prior Authorization: Health and Human Services Commission – Texas
Status: EnactedYear Enacted: 2019
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The commission shall ensure that notice sent by the commission or Medicaid managed care organization to a Medicaid recipient or provider regarding the denial of coverage of prior authorization for a service: information required by federal law; a clear and easy-to-understand explanation of the reason for the denial for the recipient; and a clinical explanation of the reason for the denial for the provider.
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