Texas § 532.0401 REVIEW OF PRIOR AUTHORIZATION AND UTILIZATION REVIEW PROCESSES.

Texas Statutes

§ 532.0401 — REVIEW OF PRIOR AUTHORIZATION AND UTILIZATION REVIEW PROCESSES.

Texas § 532.0401

Code GVGovernment Code

This text of Texas § 532.0401 (REVIEW OF PRIOR AUTHORIZATION AND UTILIZATION REVIEW PROCESSES.) is published on Counsel Stack Legal Research, covering Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Tex. Government Code Code Ann. § 532.0401 (2026).

Text

Sec. 532.0401. REVIEW OF PRIOR AUTHORIZATION AND UTILIZATION REVIEW PROCESSES. The commission shall:

(1)in accordance with an established schedule, periodically review the prior authorization and utilization review processes within the Medicaid fee-for-service delivery model to determine whether those processes need modification to reduce authorizations of unnecessary services and inappropriate use of services;

(2)monitor the prior authorization and utilization review processes within the Medicaid fee-for-service delivery model for anomalies and, on identification of an anomaly in a process, review the process for modification earlier than scheduled; and

(3)monitor Medicaid managed care organizations to ensure that the organizations are using prior authorization and utilization review p

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Sec. 532.0401. REVIEW OF PRIOR AUTHORIZATION AND UTILIZATION REVIEW PROCESSES. The commission shall:
(1) in accordance with an established schedule, periodically review the prior authorization and utilization review processes within the Medicaid fee-for-service delivery model to determine whether those processes need modification to reduce authorizations of unnecessary services and inappropriate use of services;
(2) monitor the prior authorization and utilization review processes within the Medicaid fee-for-service delivery model for anomalies and, on identification of an anomaly in a process, review the process for modification earlier than scheduled; and
(3) monitor Medicaid managed care organizations to ensure that the organizations are using prior authorization and utilization review processes to reduce authorizations of unnecessary services and inappropriate use of services.