PlainBillCongress, translated.Legislation. Context. Public interest.Referred to the Subcommittee on Employer-Employee Relations.
Congressional Research Service
Version 00 · Introduced in House · Jun 22, 1999
Independent Medical Review Act of 1999 - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to require group health plans and health insurance issuers to provide for independent review of adverse coverage determinations.Requires group health plan claims procedures to include procedures for a fair, de novo determination of medical necessity by the independent review organization without regard to the definition used by the plan, as well as notifications to participants or beneficiaries of their rights to: (1) appeal adverse determinations to utilization review agents of the plan; (2) appeal adverse determinations of such utilization review agents to independent review organizations (with procedures for such appeal); and (3) obtain immediate review by an independent review organization in cases of life-threatening conditions (with procedures for obtaining such review).Sets forth requirements for: (1) procedures for appeals of adverse decisions to the plan's utilization review agent; (2) the independent review process; and (3) certification of independent review organizations by the Secretary of Labor.Treats the independent review organization's determination as the final decision of the plan, but allows a court to vacate or modify such determination under certain circumstances.
People & committees
Rep. Sessions, Pete [R-TX-5] · R–TX
Legislative record
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Referred to the Subcommittee on Employer-Employee Relations.
Referred to the House Committee on Education and the Workforce.
Introduced in House
Introduced in House
Primary sources
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Source last updated: Mar 23, 2026. Consult Congress.gov for the current record.
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