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TITLE 28INSURANCE
PART 1TEXAS DEPARTMENT OF INSURANCE
CHAPTER 19LICENSING AND REGULATION OF INSURANCE PROFESSIONALS
SUBCHAPTER UUTILIZATION REVIEWS FOR HEALTH CARE PROVIDED UNDER WORKERS' COMPENSATION INSURANCE COVERAGE
RULE §19.2015Administrative Violations

(a) A fraudulent or deceptive act or omission in obtaining, attempting to obtain, or use of certification or registration as a URA is a violation of Insurance Code Chapter 4201.

(b) The commissioner's authority under this subchapter is in addition to any other authority to enforce a sanction, penalty, fine, forfeiture, denial, suspension, or revocation otherwise authorized by law, including remedies under Insurance Code Chapter 4201, Subchapter M, concerning Enforcement.

(c) This section does not limit the ability of the commissioner of workers' compensation or TDI-DWC to make inquiries, conduct audits, or receive and investigate complaints against URAs or personnel employed by or under contract with URAs to perform utilization review to determine compliance with or violations of Labor Code Title 5 or TDI-DWC rules. Nothing in this section prohibits joint enforcement actions by TDI and TDI-DWC or delegations of authority between TDI and TDI-DWC to enforce relevant statutes or rules.


Source Note: The provisions of this §19.2015 adopted to be effective February 20, 2013, 38 TexReg 892

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