145.024 Medical Decision Makers Licensed in Texas

145.024

Medical Decision Makers Licensed in Texas: The Texas Medical Association will (1) support legislation that would amend the Texas Insurance Code to require utilization review agents to be supervised by physicians licensed to practice medicine in the State of Texas and all denials of care based on medical necessity to be made by physicians licensed to practice medicine in the State of Texas and in the same or similar specialty as the treating physician seeking authorization of medical care; and (2) work to amend the Medical Practice Act to clearly include the supervision of persons performing precertification or preauthorization based on medical necessity as the practice of medicine; and include any denial of precertification or preauthorization of medical services based on a determination of medical necessity as the practice of medicine (Amended CL Rep. 1-A-08; amended CSE Rep. 5-A-16).

Last Updated On

October 07, 2016