Texas House Bill HB3822

Texas 2009 - 81st Regular

Caption

Relating to review of the medical necessity of certain health care provided in connection with a workers' compensation claim.

Impact

The bill modifies existing provisions in the Labor Code, particularly amending Section 413.0142. Under this legislation, if an insurance carrier does not challenge the compensability or relatedness at the time of preauthorization, they waive the right to do so later in the process. This change could enhance the efficiency of claims handling, ensuring that injured employees receive timely access to needed health care services without subsequent challenges by insurance companies. By establishing clear guidelines for handling disputes, the bill aims to provide more predictability and consistency in the workers' compensation system.

Summary

House Bill 3822 focuses on the review process of medical necessity for health care services related to workers' compensation claims. It introduces a waiver for insurance carriers regarding specific challenges they might raise in the future concerning the compensability of injuries or the relatedness of health care provided to injured employees. This waiver applies only if the insurer did not initially deny preauthorization requests on those grounds. The bill aims to streamline the process for injured workers to access necessary treatments, potentially reducing delays caused by disputes over compensability.

Contention

Notable points of contention surrounding HB 3822 may revolve around concerns from insurance providers regarding their rights to contest claims. While the bill is intended to benefit injured workers by facilitating smoother access to medical care, some insurers may argue that it limits their ability to manage risk and investigate claims adequately. Additionally, there could be pushback from employer groups worried that this could escalate costs associated with workers' compensation insurance, as preemptively waiving challenges might lead to higher treatment approvals without scrutiny.