| (a) Review of the medical necessity or appropriateness
of a health care service provided under Labor Code Chapter 408 or
Chapter 413 must be conducted under this chapter in the same manner
as reviews of utilization review decisions by health maintenance organizations.
(b) Notwithstanding subsection (a) of this section,
for independent review of adverse determinations of health care provided
under Labor Code Title 5 or Insurance Code Chapter 1305:
(1) IROs and personnel conducting independent review
must comply with Labor Code Title 5 and applicable TDI-DWC rules;
(2) in the event of a conflict between this chapter
and the Labor Code, the Labor Code controls; and
(3) in the event of a conflict between this chapter
and TDI-DWC rules, TDI-DWC rules control.
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