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Amend SB 1804, by adding a new Section 2 to the bill and
renumbering the subsequent subsection accordingly:
SECTION 2. Section 413.031, Labor Code, is amended by adding
Subsection (e-1) to read as follows:
(e-1) In performing a review of medical necessity under
Subsection (d) or (e), the independent review organization shall
consider the commission's health care reimbursement policies and
guidelines adopted under Section 413.011 if those policies and
guidelines are raised by one of the parties to the dispute. If the
independent review organization's decision is contrary to the
commission's policies or guidelines adopted under Section 413.011,
the independent review organization must indicate in the decision
the specific basis for its divergence in the review of medical
necessity. This subsection does not prohibit an independent review
organization from considering the payment policies adopted under
Section 413.011 in any dispute, regardless of whether those
policies are raised by a party to the dispute.