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You are here: Home . bulletins . 2013 . cc28

COMMISSIONER'S BULLETIN # B-0029-13

November 25, 2013


To: ALL INSURANCE COMPANIES LICENSED TO WRITE HEALTH COVERAGE IN THE STATE OF TEXAS, HEALTH MAINTENANCE ORGANIZATIONS (HMOs), INDEPENDENT REVIEW ORGANIZATIONS (IROs), AND UTILIZATION REVIEW AGENTS CONDUCTING UTILIZATION REVIEW FOR A HEALTH BENEFIT PLAN OR HEALTH INSURANCE POLICY (URAs)


Re: Temporary Standards Applicable to the Texas External Review Process

This bulletin notifies health insurance issuers, HMOs, IROs, and URAs in Texas of the impact of the U.S. Department of Health & Human Services' (HHS) Technical Release 2013-01 on external review processes. A copy of Technical Release 2013-01 is available online at www.cms.gov/CCIIO/Resources/Files/Downloads/appeals-technical-release-3-15-2013.pdf.

Technical Release 2013-01 was published on March 15, 2013. It updates and clarifies Technical Release 2011-02, and extends the applicability of the temporary NAIC-similar process standards established in Technical Release 2011-02 until January 1, 2016. Technical Release 2011-02 is available online at http://www.hrpolicy.org/downloads/2011/HHS_Technical_Release_2011-02.pdf.

Commissioner's Bulletin No. B 0051-11, issued December 28, 2011, discussed Technical Release 2011-02. The bulletin is available on the TDI website at http://www.tdi.texas.gov/bulletins/2011/index.html.

Questions regarding this bulletin should be directed via email to: LHLMgmt@tdi.texas.gov.

Julia Rathgeber
Commissioner of Insurance



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Last updated: 09/07/2014

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