TX SB2012

Requires utilization review agents to include specific identifying information in written documentation when making preauthorization determinations or appeals, including the signature, full printed name, and unique provider identifier (such as NPI) of the physician or nurse making the decision

Mandates disclosure of the credentials of the reviewing physician or nurse, including board certification, specialty expertise, and training

Requires attestations from the physician or nurse confirming they have appropriate training and expertise in the relevant field of medicine to make informed medical necessity decisions

Requires attestation that the reviewing physician or nurse has no conflict of interest that would interfere with their ability to make an impartial determination on the specific patient case

Requires documentation of the amount of time the physician or nurse spent evaluating medical records before making the determination; applies to preauthorization requests made on or after January 1, 2026