Texas Administrative Code
Title 28 - INSURANCE
Part 1 - TEXAS DEPARTMENT OF INSURANCE
Chapter 12 - INDEPENDENT REVIEW ORGANIZATIONS
Subchapter B - CERTIFICATE OF REGISTRATION FOR INDEPENDENT REVIEW ORGANIZATIONS
Section 12.111 - Regulatory Requirements Subsequent to a Certificate of Registration

Universal Citation: 28 TX Admin Code § 12.111

Current through Reg. 50, No. 26; June 27, 2025

(a) The IRO must report any material changes to the information required in the IRO application form required by § 12.103 and § 12.108 of this chapter, including changes relating to physicians and providers performing independent review, no later than the 30th day after the date on which the change takes effect.

(b) If the material change is a relocation of the primary office:

(1) the organization must inform the department that the location is available for inspection by the department at least 30 days before the date of the relocation;

(2) on request of the department, an officer must attend the inspection; and

(3) if the inspection is a result of a sale under § 12.110 of this chapter, the inspection may include verification that the IRO complies with the requirements in § 12.103(11) of this chapter.

(c) The IRO is exempt from compliance with subsection (a) of this section in the event that a contracted specialist IRO reviewer is unavailable for review on a specific case, and subsequent immediate contracting with a new specialist IRO reviewer is necessary to complete independent review on a specific case within the time frames set out in this chapter.

(d) The IRO must notify the department within 10 days of any contracts entered into under subsection (c) of this section, and must include in the notification a complete explanation of the circumstances necessitating the new contracts.

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