Monday, August 30, 2021

TDI issues bulletin on adverse determinations

TDI issues bulletin on adverse determinations

The Texas Department of Insurance has issued a bulletin reminding health maintenance organizations, health insurers, and utilization review agents that an adverse determination based on a service being experimental or investigational is subject to the state’s utilization review requirements. Workers' compensation carriers are reminded that an adverse determination is subject to the utilization review requirements provided under Texas law.

 

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