| 1 | 1 | | 85R8209 KKR-F |
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| 2 | 2 | | By: Oliveira H.B. No. 2058 |
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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 preauthorization and concurrent review of certain |
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| 8 | 8 | | health care 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 413.014, Labor Code, is amended by |
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| 11 | 11 | | amending Subsection (c) and adding Subsection (c-1) to read as |
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| 12 | 12 | | follows: |
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| 13 | 13 | | (c) The commissioner's rules adopted under this section |
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| 14 | 14 | | must provide that preauthorization and concurrent review are |
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| 15 | 15 | | required at a minimum for: |
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| 16 | 16 | | (1) spinal surgery, as provided by Section 408.026; |
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| 17 | 17 | | (2) work-hardening or work-conditioning services |
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| 18 | 18 | | [provided by a health care facility that is not credentialed by an |
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| 19 | 19 | | organization recognized by commissioner rules]; |
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| 20 | 20 | | (3) inpatient hospitalization, including any |
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| 21 | 21 | | procedure and length of stay; |
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| 22 | 22 | | (4) physical and occupational therapy; |
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| 23 | 23 | | (5) outpatient or ambulatory surgical services, as |
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| 24 | 24 | | defined by commissioner rule; and |
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| 25 | 25 | | (6) any investigational or experimental services or |
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| 26 | 26 | | devices. |
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| 27 | 27 | | (c-1) Notwithstanding Subsection (c)(2), the commissioner |
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| 28 | 28 | | by rule may exempt from preauthorization and concurrent review |
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| 29 | 29 | | work-hardening or work-conditioning services provided by a health |
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| 30 | 30 | | care facility that is credentialed by an organization designated by |
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| 31 | 31 | | commissioner rule. |
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| 32 | 32 | | SECTION 2. The change in law made by this Act applies only |
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| 33 | 33 | | to health care services provided on or after the effective date of |
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| 34 | 34 | | this Act in conjunction with a claim for workers' compensation |
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| 35 | 35 | | benefits, regardless of the date on which the compensable injury |
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| 36 | 36 | | that is the basis of the claim occurred. |
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| 37 | 37 | | SECTION 3. This Act takes effect September 1, 2017. |
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