| 1 | 1 | | 81R11709 PB-D |
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| 2 | 2 | | By: Lucio III H.B. No. 4624 |
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| 3 | 3 | | |
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| 4 | 4 | | |
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| 5 | 5 | | A BILL TO BE ENTITLED |
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| 6 | 6 | | AN ACT |
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| 7 | 7 | | relating to certain requirements for doctors providing |
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| 8 | 8 | | professional services under the workers' compensation system. |
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| 9 | 9 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 10 | 10 | | SECTION 1. Section 408.0043, Labor Code, is amended by |
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| 11 | 11 | | amending Subsection (b) and adding Subsection (c) to read as |
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| 12 | 12 | | follows: |
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| 13 | 13 | | (b) A person described by Subsection (a) who reviews a |
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| 14 | 14 | | specific workers' compensation case must: |
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| 15 | 15 | | (1) hold a professional certification in a health care |
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| 16 | 16 | | specialty appropriate to the type of health care that the injured |
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| 17 | 17 | | employee is receiving; and |
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| 18 | 18 | | (2) receive at least 50 percent of the person's annual |
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| 19 | 19 | | income through direct patient care of patients in this state. |
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| 20 | 20 | | (c) A person may not satisfy the direct patient care |
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| 21 | 21 | | requirement under Subsection (b) through: |
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| 22 | 22 | | (1) the provision of professional opinions regarding |
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| 23 | 23 | | an individual who is not a patient of the person; or |
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| 24 | 24 | | (2) health care consulting work. |
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| 25 | 25 | | SECTION 2. Section 408.0044, Labor Code, is amended by |
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| 26 | 26 | | amending Subsection (b) and adding Subsection (c) to read as |
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| 27 | 27 | | follows: |
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| 28 | 28 | | (b) A person described by Subsection (a) who reviews a |
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| 29 | 29 | | dental service provided in conjunction with a specific workers' |
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| 30 | 30 | | compensation case must: |
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| 31 | 31 | | (1) be licensed to practice dentistry in this state; |
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| 32 | 32 | | and |
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| 33 | 33 | | (2) receive at least 50 percent of the person's annual |
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| 34 | 34 | | income through direct patient care of patients in this state. |
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| 35 | 35 | | (c) A person may not satisfy the direct patient care |
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| 36 | 36 | | requirement under Subsection (b) through: |
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| 37 | 37 | | (1) the provision of professional opinions regarding |
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| 38 | 38 | | an individual who is not a patient of the person; or |
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| 39 | 39 | | (2) dental health care consulting work. |
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| 40 | 40 | | SECTION 3. Section 408.0045, Labor Code, is amended by |
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| 41 | 41 | | amending Subsection (b) and adding Subsection (c) to read as |
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| 42 | 42 | | follows: |
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| 43 | 43 | | (b) A person described by Subsection (a) who reviews a |
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| 44 | 44 | | chiropractic service provided in conjunction with a specific |
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| 45 | 45 | | workers' compensation case must: |
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| 46 | 46 | | (1) be licensed to engage in the practice of |
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| 47 | 47 | | chiropractic in this state; and |
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| 48 | 48 | | (2) receive at least 50 percent of the person's annual |
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| 49 | 49 | | income through direct patient care of patients in this state. |
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| 50 | 50 | | (c) A person may not satisfy the direct patient care |
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| 51 | 51 | | requirement under Subsection (b) through: |
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| 52 | 52 | | (1) the provision of professional opinions regarding |
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| 53 | 53 | | an individual who is not a patient of the person; or |
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| 54 | 54 | | (2) chiropractic health care consulting work. |
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| 55 | 55 | | SECTION 4. Section 413.031(e-2), Labor Code, is amended to |
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| 56 | 56 | | read as follows: |
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| 57 | 57 | | (e-2) Notwithstanding Section 4202.002, Insurance Code, an |
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| 58 | 58 | | independent review organization that uses doctors to perform |
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| 59 | 59 | | reviews of health care services provided under this title may only |
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| 60 | 60 | | use doctors who: |
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| 61 | 61 | | (1) are licensed to practice in this state; and |
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| 62 | 62 | | (2) receive at least 50 percent of the doctor's annual |
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| 63 | 63 | | income through direct patient care of patients in this state. |
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| 64 | 64 | | SECTION 5. The change in law made by this Act applies only |
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| 65 | 65 | | to professional services provided in conjunction with a claim for |
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| 66 | 66 | | workers' compensation benefits based on a compensable injury that |
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| 67 | 67 | | occurs on or after the effective date of this Act. Professional |
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| 68 | 68 | | services provided in conjunction with a claim based on a |
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| 69 | 69 | | compensable injury that occurs before that date is governed by the |
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| 70 | 70 | | law in effect on the date the compensable injury occurred, and the |
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| 71 | 71 | | former law is continued in effect for that purpose. |
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| 72 | 72 | | SECTION 6. This Act takes effect September 1, 2009. |
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