Texas Register
(22 TexReg 10896).
This new section is necessary to set forth the parameters of an advisory
committee to assist the commissioner in implementing and enforcing the Health
Care Utilization Review Agents statute appearing at Insurance Code Article
21.58A. The rule defines and describes the duties, make-up and duration of
the Utilization Review Advisory Committee, pursuant to Insurance Code Article
21.58A, §13. The Utilization Review Advisory Committee is necessary
to assist the commissioner in developing rules for utilization review. It
is anticipated that at least one area of utilization review rules will be
necessary in the coming year. The Utilization Review Advisory Committee is
terminated as of December 31, 1998. Setting a firm termination date for the
committee encourages it to fulfill its statutory purpose efficiently and
timely.
This section describes the purpose of the Utilization Review Advisory Committee,
which is to advise the commissioner in developing rules and regulations for
utilization review, and enumerates the tasks by which the committee is to
achieve its purpose. The advisory committee is to be comprised of one representative
from each of the following: Office of Public Insurance Counsel, an insurance
company, an HMO, a group hospital service corporation, a utilization review
agent, a consumer group, an employer, a physician, a dentist, a hospital,
a registered nurse, and other health care providers. The advisory committee
is to terminate on December 31, 1998 unless its duration is extended by the
commissioner.
No comments were received regarding adoption of the new section.
The new section is adopted under the Insurance Code, Articles
21.58A, §13 and 1.03A. Insurance Code Article 21.58A, §13 directs
the commissioner to appoint an advisory committee to assist and advise the
commissioner in developing rules and regulations for utilization review.
Article 1.03A provides that the Commissioner of Insurance may adopt rules
and regulations to execute the duties and functions of the Texas Department
of Insurance. The Government Code, §§2001.004 et seq. authorizes
and requires each state agency to adopt rules of practice setting forth the
nature and requirement of available procedures and prescribes the procedures
for adoption of rules by a state administrative agency.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Issued in Austin, Texas, on December 17, 1997.
TRD-9716869
Lynda H. Nesenholtz
Assistant General Counsel
Texas Department of Insurance
Effective date: January 6, 1998
Proposal publication date: November 7, 1997
For further information, please call: (512) 463-6327