Texas Administrative Code
Title 28 - INSURANCE
Part 1 - TEXAS DEPARTMENT OF INSURANCE
Chapter 19 - LICENSING AND REGULATION OF INSURANCE PROFESSIONALS
Subchapter U - UTILIZATION REVIEWS FOR HEALTH CARE PROVIDED UNDER WORKERS' COMPENSATION INSURANCE COVERAGE
Section 19.2012 - URA's Telephone Access and Procedures for Certain Drug Requests and Post-Stabilization Care
Universal Citation: 28 TX Admin Code § 19.2012
Current through Reg. 50, No. 13; March 28, 2025
(a) A URA must have appropriate personnel reasonably available by toll-free telephone at least 40 hours per week during normal business hours in both Central Time and Mountain Time, to discuss an injured employee's care and to respond to telephone review requests.
(b) A URA must have procedures that the URA will implement when responding to requests for:
(1) drugs that require preauthorization, in
situations in which the injured employee has received or is currently receiving
the requested drugs and an adverse determination could lead to a medical
emergency; and
(2)
post-stabilization care and pain management medication immediately subsequent
to surgery or emergency treatment, as requested by the treating physician or
provider of record.
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