tx-May152026-45: 28 TAC §5.9970, §5.9971 (Amendment) — Property and Casualty Insurance
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The Texas Department of Insurance (TDI) proposes to amend 28 TAC §12.601, concerning review of preauthorization exemptions by independent review organizations (IROs). The amended section implements House Bill 3812, 89th Legislature, 2025. In a separate rulemaking published in this issue of the Texas Register, TDI proposes to amend related rules in 28 TAC §§19.1730 - 19.1733 to address other provisions related to preauthorization exemptions that are impacted by HB 3812. EXPLANATION. Amending §12.601 is necessary to implement HB 3812, which amended Insurance Code §4201.656(a) to specify that a physician or provider has a right to an independent review of a health plan's determination to deny a preauthorization exemption. Descriptions of the section's proposed amendments follow. Section 12.601. Subsection (e) of §12.601 is amended to clarify that it applies with respect to a review of a rescission, and to update the reference to the title of §19.1733 consistent with proposed amendments to Chapter 19 included in this Texas Register issue. New subsection (f) is added to address a review of a preauthorization exemption denial, consistent with proposed §19.1733(f), which permits an...
The agency’s own summary, as published.
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