81R237 ALB-F
By: Watson S.B. No. 1925
A BILL TO BE ENTITLED
AN ACT
relating to certain services provided by the office of injured
employee counsel under the workers' compensation program of this
state.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter C, Chapter 404, Labor Code, is
amended by adding Section 404.1015 to read as follows:
Sec. 404.1015. REFUSAL TO PROVIDE OR TERMINATION OF
SERVICES. (a) The public counsel may refuse to provide or may
terminate the services of the office to any claimant who:
(1) is abusive or violent to or who threatens any
employee of the office;
(2) makes unreasonable demands for office services or
for assistance in claiming benefits not provided by law; or
(3) commits or threatens to commit a criminal act in
pursuit of a workers' compensation claim.
(b) If the public counsel determines under Subsection (a)
that the services of the office should be refused or terminated, the
office shall inform the affected claimant in writing and notify the
division.
(c) The office shall notify the appropriate law enforcement
authority if the office becomes aware that the claimant or a person
acting on the claimant's behalf commits or threatens to commit a
criminal act.
SECTION 2. Section 404.105, Labor Code, is amended to read
as follows:
Sec. 404.105. AUTHORITY TO ASSIST INDIVIDUAL INJURED
EMPLOYEES IN ADMINISTRATIVE PROCEDURES. (a) The office, through
the ombudsman program, may appear before the commissioner, [or]
division, or State Office of Administrative Hearings to provide
assistance to [on behalf of] an individual injured employee during:
(1) a workers' compensation [an] administrative
dispute resolution process; or
(2) an enforcement action by the department or
division against an employee for a violation of the Texas Workers'
Compensation Act.
(b) This chapter may not be construed as requiring or
allowing legal representation for an individual injured employee by
an office attorney or ombudsman in any proceeding.
SECTION 3. Section 404.109, Labor Code, is amended to read
as follows:
Sec. 404.109. INJURED EMPLOYEE RIGHTS; NOTICE. The public
counsel shall adopt, in the form and manner prescribed by the public
counsel, [submit to the division and the department for adoption by
the commissioners] a notice of injured employee rights and
responsibilities to be distributed by the division as provided by
commissioner or [and] commissioner of insurance rules.
SECTION 4. Section 404.110, Labor Code, is amended to read
as follows:
Sec. 404.110. APPLICABILITY TO PUBLIC COUNSEL OF
CONFIDENTIALITY REQUIREMENTS. (a) Confidentiality requirements
applicable to examination reports and to the commissioner of
insurance under Sections 401.058, 401.105, 401.106, 441.201, and
501.158 [Article 1.18], Insurance Code, as applicable, and Section
404.111, [and to the commissioner of insurance under Section 3A,
Article 21.28-A, Insurance Code,] apply to the public counsel.
(b) An employee of the office may not be compelled to
disclose information communicated to the employee by a claimant on
any matter relating to the claimant's claim. This subsection does
not prohibit or alter the office's duty to notify appropriate law
enforcement authorities under Section 404.1015(c).
SECTION 5. Section 404.111, Labor Code, is amended to read
as follows:
Sec. 404.111. ACCESS TO INFORMATION. (a) Except as
otherwise provided by this section, the [The] office may access
information from an executive agency that is otherwise confidential
under a law of this state if that information is necessary for the
performance of the duties of the office, including information made
confidential under:
(1) Section 843.006, Insurance Code;
(2) Chapter 108, Health and Safety Code;
(3) Chapter 552, Government Code; and
(4) Sections 402.083, 402.091, and 402.092 of this
code.
(b) The office may not access information under Subsection
(a) that is an attorney-client communication or an attorney work
product, or other information protected by a privilege recognized
by the Texas Rules of Civil Procedure or the Texas Rules of
Evidence.
(c) In furtherance of assisting an employee under Section
404.105(a)(2), the office may not access information under
Subsection 404.111(a) to which the employee is not otherwise
entitled. If the office possesses any information made
confidential by the Texas Workers' Compensation Act or any other
laws of this state to which the employee is not otherwise entitled,
that information may not be disclosed to the employee or any other
party assisting an employee under Section 404.105(a)(2). Nothing
in this subsection prohibits or alters the office's duty to notify
appropriate law enforcement authorities under Section 404.1015(c).
(d) Except as provided by this section [On request by the
public counsel], the division or the department shall provide any
information or data requested by the public counsel [office] in
furtherance of the duties of the office under this chapter.
(e) [(c)] The office may not make public any confidential
information provided to the office under this chapter. Except as
provided by Subsection (c), the office [but] may disclose a summary
of the information that does not directly or indirectly identify
the individual or entity that is the subject of the
information. The office may not release, and an individual or
entity may not gain access to, any information that:
(1) could reasonably be expected to reveal the
identity of a health care provider or an injured employee;
(2) reveals the zip code of an injured employee's
primary residence;
(3) discloses a health care provider discount or a
differential between a payment and a billed charge; or
(4) relates to an actual payment made by a payer to an
identified health care provider.
(f) [(d)] Information collected or used by the office under
this chapter is subject to the confidentiality provisions and
criminal penalties of:
(1) Section 81.103, Health and Safety Code;
(2) Section 311.037, Health and Safety Code;
(3) Chapter 159, Occupations Code; [and]
(4) Chapter 552, Government Code; and
(5) Sections [Section] 402.091 and 402.092 of this
code.
(g) [(e)] Information on health care providers and injured
employees that is in the possession of the office, and any
compilation, report, or analysis produced from the information that
identifies providers and injured employees is not:
(1) subject to discovery, subpoena, or other means of
legal compulsion for release to any individual or entity; or
(2) admissible in any civil, administrative, or
criminal proceeding.
(h) [(f)] Notwithstanding Subsection (e)(2) [(c)(2)], the
office may use zip code information to analyze information on a
geographical basis.
SECTION 6. This Act takes effect September 1, 2009.