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(a).(b) Utilization review under this section is subject to Chapter 4201.Tex. Ins. Code § 1377.052
Added by Acts 2009, 81st Leg., R.S., Ch. 1129, Sec. 1, eff. 9/1/2009.