• Increase Text Icon
  • Decrease Text Icon
  • Email Icon
  • Print this page
You are here: Home . bulletins . 2016 . b-0003-16

COMMISSIONER'S BULLETIN # B-0003-16

March 08, 2016


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


Re: TEMPORARY STANDARDS APPLICABLE TO 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) update on external review processes which includes extending the application of Texas procedures governing independent review through December 31, 2017.  A copy of the entire rule is available online in the Federal Register, Volume 80, No. 222 at www.gpo.gov/fdsys/pkg/FR-2015-11-18/pdf/2015-29294.pdf.

The Extension of the Transition Period for State External Review Processes is located at pages 72206- 72209 of Federal Register, Volume 80, No. 222.

The rule updates and clarifies Technical Release 2013-01, and extends the applicability of the temporary NAIC-similar process standards established in Technical Release 2013-01 until December 31, 2017.  Technical Release 2013-01 is available online at www.dol.gov/ebsa/newsroom/tr13-01.html.

Commissioner's Bulletin No. B-0029-13, issued November 25, 2013, discussed Technical Release 2013-01.  The bulletin is available on the TDI website at www.tdi.texas.gov/Bulletins/2013/cc28.html.

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

Doug Slape, Deputy Commissioner
Financial Regulation Division



For more information contact:

Last updated: 03/08/2016

Contact Information and Other Helpful Links