<<Prev Rule

Texas Administrative Code

Next Rule>>
TITLE 28INSURANCE
PART 1TEXAS DEPARTMENT OF INSURANCE
CHAPTER 3LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES
SUBCHAPTER HHSTANDARDS FOR REASONABLE COST CONTROL AND UTILIZATION REVIEW FOR CHEMICAL DEPENDENCY TREATMENT CENTERS
RULE §3.8002Purpose and General Provisions

(a) Purpose. The purpose of this subchapter is to provide:

  (1) standards for use by payors and chemical dependency treatment providers for the reasonable control of costs necessary for inpatient and outpatient treatment of chemical dependency; and

  (2) standards for appropriate utilization review and necessary extension of treatment.

(b) Applicability of this subchapter to control costs. To reasonably control the costs of inpatient and outpatient treatment of chemical dependency, benefits for each individual should be provided for the appropriate level in accordance with the provisions of this subchapter.

(c) Reporting of misuse or abuse of standards. Misuse or abuse of the standards in this subchapter by qualified credentialed counselors shall be reported to the appropriate credentialing entity. Misuse or abuse of these standards by payors shall be reported to the Texas Department of Insurance and the Texas Commission on Alcohol and Drug Abuse. Misuse of these standards by treatment providers shall be reported to the Texas Commission on Alcohol and Drug Abuse and the Texas Department of Insurance.

(d) Confidentiality of medical records. Payors and providers shall preserve the confidentiality of individual medical records to the extent required by law.

(e) Severability. If any provision of the sections in this subchapter or its application to any person or circumstance is held to be invalid, such invalidity shall not affect other provisions or applications of sections which can be given effect without the invalid provisions, and to this end, the provisions of each section are declared to be severable.


Source Note: The provisions of this §3.8002 adopted to be effective August 28, 1991, 16 TexReg 4403; amended to be effective February 14, 1999, 24 TexReg 713

Link to Texas Secretary of State Home Page | link to Texas Register home page | link to Texas Administrative Code home page | link to Open Meetings home page