Search Tips Targeted Search by Area Website FAQs Notice of SAI Plus enforcement action. International Rehabilitation Associates, doing business as Intracorp, is a Philadelphia-based firm certified to act as a utilization review agent in Texas. When it failed to notify patients of their independent review rights, Intracorp was under contract to perform utilization review for Connecticut General Life Insurance Co., an affiliate within the same holding company system. The consent order was signed Wednesday, May 30, 2001. Several similar cases are under investigation by the Legal and Compliance Division of the Texas Department of Insurance.
Independent review is one of the most important rights held by health plan members in Texas.
Utilization review agents are responsible for providing this vital information, and when they don't, the system breaks down. We at TDI are determined to enforce this requirement. Texas' system of binding independent review was established by the same 1997 law that allows patients to sue HMOs and insurance for medical malpractice. When a utilization review agent determines that a particular treatment is not medically necessary, it must notify the patient of the right to independent review. The notice must include the necessary forms to apply for such a review.