Section 12.204 - Prohibitions of Certain Activities and Relationships of Independent Review Organizations and Individuals or Entities Associated with Independent Review Organizations(a) An IRO must not set or impose any notice or other review procedures that are contrary to the requirements of the health insurance policy or health benefit plan unless those requirements are set out in this chapter or Texas law.(b) An IRO may not permit or provide compensation or anything of value to its physicians or providers that would affect, directly or indirectly, an independent review decision.(c) An IRO may not operate out of the same office or other facility as another IRO. (1) This prohibition extends to the shared use by IROs of the resources and staff that comprise an office, including office space, telephone and fax lines, electronic equipment, supplies, and clerical staff.(2) This prohibition does not extend to the use of subcontractor services or personnel employed by or under contract with the IRO to perform independent review.(d) An individual who serves as an officer, director, manager, executive, or supervisor of an IRO may not serve as an officer, director, manager, executive, supervisor, employee, agent, or independent contractor of another IRO.(e) An individual or entity may not own more than one IRO.(f) An individual may not own stock in more than one IRO.(g) An individual may not serve on the board of more than one IRO.(h) An individual who has served on the board of an IRO that has had its certificate of registration revoked for cause may not serve on the board of another IRO earlier than the fifth anniversary of the date the revocation occurred.28 Tex. Admin. Code § 12.204
The provisions of this §12.204 adopted to be effective November 26, 1997, 22 TexReg 11363; amended to be effective December 26, 2010, 35 TexReg 11281; Amended by Texas Register, Volume 40, Number 19, May 8, 2015, TexReg 2565, eff. 7/7/2015