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Will networks be required to comply with Division rules specifying which health care treatments and services require the insurance carrier’s express preauthorization or concurrent review?

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Will networks be required to comply with Division rules specifying which health care treatments and services require the insurance carrier’s express preauthorization or concurrent review?

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A. No. If a network or carrier uses a preauthorization process within a network, the requirements of Insurance Code Chapter 1305 and applicable TDI rules apply. A network or carrier may establish its own list of which health care treatments and services require preauthorization or concurrent review within a network.

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