Texas House Bill HB528

Texas 2011 - 82nd Regular

• Out of House Committee: 4/13/11
• Voted on by House: 5/5/11
• Out of Senate Committee: 5/17/11
• Voted on by Senate: 5/24/11
• Engrossed: 5/5/11
• Governor Action: 6/17/11
• Refer: 5/9/11
• Report Pass: 5/17/11
• Enrolled: 5/26/11
• Passed: 6/17/11

Caption

Relating to the provision of pharmaceutical services through informal and voluntary networks in the workers' compensation system; providing an administrative violation.

Impact

The introduction of HB 528 represents a significant modification to existing labor and insurance laws, particularly those governing workers' compensation. The bill amends various sections of the Labor Code concerning the management of pharmaceutical services within the realm of workers' compensation. By allowing informal and voluntary networks, it creates avenues for direct negotiations between insurance carriers and healthcare providers. This is expected to streamline processes, potentially leading to increased competition among providers, which in turn might minimize costs for both insurers and injured employees.

Summary

House Bill 528 aims to enhance the provision of pharmaceutical services through informal and voluntary networks within the workers' compensation system in Texas. The bill outlines new procedures for reimbursement of pharmaceutical services by insurance carriers based on specific fee schedules. These schedules may differ from those traditionally authorized under existing guidelines, allowing greater flexibility for insurers and healthcare providers to negotiate terms. By enabling informal agreements, the bill seeks to improve access to necessary medications for injured workers, highlighting an intention to balance cost-efficiency with healthcare accessibility.

Contention

Despite the potential benefits outlined by proponents of the bill, there remain concerns among certain stakeholders regarding the implications of allowing informal and voluntary networks. Critics argue that the flexibility granted within these networks may lead to inconsistencies in service delivery and reimbursement rates, potentially undermining protections for injured workers. There is a worry that the administrative provisions might not sufficiently safeguard against inequities, leaving room for violations that could adversely affect the quality and timeliness of care delivered to injured workers. As the bill further constitutes administrative violations for non-compliance with its stipulations, the enforcement mechanisms and the impact on providers remain subjects of debate.