28 TAC § 19.1701. General Provisions, DIVISION 1. UTILIZATION REVIEWS

TexasRegulations

Ask Donna

How this section applies to your facts.

Texas Administrative Code › Title 28 INSURANCE › Part 1 TEXAS DEPARTMENT OF INSURANCE › Chapter 19 LICENSING AND REGULATION OF INSURANCE PROFESSIONALS › 28 TAC § 19.1701

This text was captured on Aug 14, 2026. It is a snapshot, not a live feed, so check the official code before relying on it.

Text

(a) Statutory basis. This subchapter implements Insurance Code Chapter 4201, concerning Utilization Review Agents.

(b) Severability. If a court of competent jurisdiction holds that any provision of this subchapter or its application to any person or circumstance is invalid for any reason, the invalidity does not affect other provisions or applications of this subchapter that can be given effect without the invalid provision or application, and to this end the provisions of this subchapter are severable.

(c) Purpose. The purpose of this subchapter is to:

(1) promote the delivery of quality health care in a cost-effective manner, including protection of enrollee safety;

(2) ensure that URAs adhere to reasonable standards for conducting utilization reviews;

(3) foster greater coordination and cooperation between health care providers and URAs;

(4) improve communications and knowledge of medical benefits among all parties concerned before expenses are incurred; and

(5) ensure that URAs maintain the confidentiality of medical records in accord with applicable law.

This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.

A word about cookies

We need a few to keep you signed in and the library working. The rest help us see which pages people use and where they get stuck. They stay off unless you say yes.

28 TAC § 19.1701. General Provisions, DIVISION 1. UTILIZATION REVIEWS · 28 Tex. Admin. Code § 19.1701 | Frix