Texas § IN.1305.351 - UTILIZATION REVIEW IN NETWORK
Full text of Texas The Texas Constitution § IN.1305.351 — UTILIZATION REVIEW IN NETWORK, with citation guidance and answers to common questions.
§ IN.1305.351. UTILIZATION REVIEW IN NETWORK
UTILIZATION REVIEW IN NETWORK. (a) The requirements of Chapter 4201 apply to utilization review conducted in relation to claims in a workers' compensation health care network. In the event of a conflict between Chapter 4201 and this chapter, this chapter controls. (b) Any screening criteria used for utilization review related to a workers' compensation health care network must be consistent with the network's treatment guidelines. (c) The preauthorization requirements of Section 413.014 , Labor Code, and commissioner of workers' compensation rules adopted under that section, do not apply to health care provided through a workers' compensation network. If a network or carrier uses a preauthorization process within a network, the requirements of this subchapter and commissioner rules apply. A network or an insurance carrier may not require preauthorization of treatments and services for a medical emergency. (d) A utilization review agent or an insurance carrier that uses doctors to perform reviews of health care services provided under this chapter, including utilization review, or peer reviews under Section 408.0231 (g), Labor Code, may only use doctors licensed to practice in this state. Added by Acts 2005, 79th Leg., Ch. 265 (H.B. 7 ), Sec. 4.02, eff. September 1, 2005. Amended by: Acts 2007, 80th Leg., R.S., Ch. 134 (H.B. 1006 ), Sec. 6, eff. September 1, 2007. Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636 ), Sec. 2G.010, eff. April 1, 2009. Acts 2009, 81st Leg., R.S., Ch. 1330 (H.B. 4290 ), Sec. 5, eff. September 1, 2009. Acts 2019, 86th Leg., R.S., Ch. 1218 (S.B. 1742 ), Sec. 3.11, eff. September 1, 2019.
Frequently Asked Questions About Texas § IN.1305.351
What does The Texas Constitution § IN.1305.351 cover?
Section IN.1305.351 ("UTILIZATION REVIEW IN NETWORK") is part of the The Texas Constitution, the codified statutory law of Texas. It sets out the legal rule or procedure described in the text above. Statutes are amended regularly, so always verify against the official source.
How do I cite Texas § IN.1305.351?
A common citation format is "The Texas Constitution § IN.1305.351" (Texas). Legal writing may require the code abbreviation, section number, and year or edition. Match the style required by your court, professor, or publisher.
Is this the official text of Texas law?
No. This page is for research and education and may not include the most recent amendments. For official current law, check the Texas official source linked on this page or consult a licensed Texas attorney.
How does Texas § IN.1305.351 apply to my situation?
Statutes are interpreted in context, and application depends on your specific facts. Only a licensed attorney in Texas can advise on how this section applies to you. Contact your state or local bar association for a referral.
Sources & Verification
Not legal advice. Verify against the official source and consult a licensed attorney in Texas.