| (a) Statutory basis. This subchapter implements Insurance
Code Chapter 4201, concerning Utilization Review Agents.
(b) Severability. If a court of competent jurisdiction
holds that any provision of this subchapter or its application to
any person or circumstance is invalid for any reason, the invalidity
does not affect other provisions or applications of this subchapter
that can be given effect without the invalid provision or application,
and to this end the provisions of this subchapter are severable.
(c) Purpose. The purpose of this subchapter is to:
(1) promote the delivery of quality health care in
a cost-effective manner, including protection of enrollee safety;
(2) ensure that URAs adhere to reasonable standards
for conducting utilization reviews;
(3) foster greater coordination and cooperation between
health care providers and URAs;
(4) improve communications and knowledge of medical
benefits among all parties concerned before expenses are incurred;
and
(5) ensure that URAs maintain the confidentiality of
medical records in accord with applicable law.
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