Tex. Ins. Code §§ 4201.201 through 4201.207: Utilization Review: Relations with Patients and Health Care Providers – Texas

Status: Enacted
Year Enacted: 2005
Year Amended: 2015
File: Download

A utilization review agent may not engage in unnecessary or unreasonable repetitive contacts with a patient or provider. The frequency of contact shall be based on the complexity of the patient’s condition and treatment plan. A utilization review agent shall establish and maintain a complaint system that provides for resolution of oral or written complaints by enrollees, patients, and health care providers.


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