TX SB177

Health maintenance organizations and insurers must have personnel available at toll-free telephone numbers 24 hours a day, seven days a week, including legal holidays, to handle verification and preauthorization requests (replacing previous limited hours of 6 a.m.-6 p.m. weekdays and 9 a.m.-noon on weekends/holidays)

Response time for recorded verification calls is reduced from two calendar days to two hours after the call is received

Response time for preauthorization request calls is reduced from 24 hours to two hours after the call is received

Utilization review agents must have personnel available by toll-free telephone 24/7 including holidays (replacing the previous 40 hours per week minimum during normal business hours)

When personnel are unavailable due to circumstances beyond reasonable control, phone systems must still accept or record calls, with responses required within two hours (reduced from the previous second working day deadline)