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(a) The State Board of Health may revoke or deny a certificate if the holder does not comply with performance assurances under this section, violates any provision of this subchapter, or violates any rule adopted pursuant to this subchapter.
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(b) The board shall deny a certificate to any applicant if upon review of the application the board finds that the applicant proposing to conduct a utilization review does not:
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(1) Have available the services of a sufficient number of qualified medical professionals supported and supervised by appropriate physicians to carry out its utilization review activities;
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(2) Meet any applicable rules the board adopted under this subchapter relating to the qualifications of private review agents or the performance of utilization review; and
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(3) Provide assurances satisfactory to the board that:
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(A) The procedure and policies of the private review agent will protect the confidentiality of medical records; and
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(B) The review agent will be reasonably accessible to patients and providers for five (5) working days a week during normal business hours in this state.
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