Tex. Ins. Code Section 1377.052
Utilization Review

(a)

A utilization review agent acting on behalf of a health benefit plan issuer may review a treating physician’s determination of the medical necessity of the use of an amino acid-based elemental formula for the treatment of an enrollee who is diagnosed with a disease or disorder listed in Section 1377.051 (Required Coverage for Certain Amino Acid-based Elemental Formulas)(a).

(b)

Utilization review under this section is subject to Chapter 4201 (Utilization Review Agents).
Added by Acts 2009, 81st Leg., R.S., Ch. 1129 (H.B. 2000), Sec. 1, eff. September 1, 2009.

Source: Section 1377.052 — Utilization Review, https://statutes.­capitol.­texas.­gov/Docs/IN/htm/IN.­1377.­htm#1377.­052 (accessed May 26, 2025).

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May 26, 2025

§ 1377.052. Utilization Review's source at texas​.gov