The commissioner by rule shall require referral by random assignment of adverse determinations under Subchapter I, Chapter 4201, to independent review organizations. On referral of a determination, the commissioner shall notify:
(1) the utilization review agent;
(2) the payor;
(3) the independent review organization;
(4) the patient, as defined by Section 4201.002, or the patient’s representative; and
(5) the provider of record as defined by Section 4201.002.