Texas 2017 - 85th Regular

Texas House Bill HB3494 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	85R26760 KKR-F
2		-	By: Shine, Villalba, et al. H.B. No. 3494
3		-	Substitute the following for H.B. No. 3494:
4		-	By: Miller C.S.H.B. No. 3494
	1	+	85R2857 KKR-D
	2	+	By: Shine H.B. No. 3494
5	3
6	4
7	5		A BILL TO BE ENTITLED
8	6		AN ACT
9	7		relating to a demonstration program for real-time processing of
10	8		workers' compensation authorizations of payment for medical
11	9		services and medical bills.
12	10		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
13	11		SECTION 1. Subchapter B, Chapter 412, Labor Code, is
14	12		amended by adding Section 412.0129 to read as follows:
15	13		Sec. 412.0129. AUTHORIZATION OF PAYMENT FOR MEDICAL
16	14		SERVICES AND MEDICAL BILLING REAL-TIME PROCESSING DEMONSTRATION
17		-	PROGRAM. (a) The office ~~may~~ develop and implement a ~~demonstration~~
18		-	program for processing workers' compensation ~~authorizations of~~
19		-	payment for medical services and medical bills in ~~real time if the~~
20		-	~~office determines that the program would be cost-effective~~.
	15	+	PROGRAM. (a) The office shall develop and implement a
	16	+	demonstration program for processing workers' compensation
	17	+	authorizations of payment for medical services and medical bills in
	18	+	real-time.
21	19		(b) The demonstration program described by Subsection (a)
22	20		must include:
23		-	(1) a secure single platform, ~~Internet~~-based portal
24		-	~~for use~~ by the office, state agencies, injured employees, and
25		-	~~health care~~ providers;
	21	+	(1) a secure single platform, web-based portal for use
	22	+	by the office, state agencies, injured employees, and health care
	23	+	providers;
26	24		(2) the ability to collect, input, and transmit
27	25		administrative and clinical data, including:
28	26		(A) patient information;
29	27		(B) provider contracts;
30	28		(C) treatment guidelines; and
31	29		(D) other information the office considers
32	30		necessary for processing authorizations and medical bills;
33	31		(3) an automated process to streamline requests for
34	32		authorizations of payment for medical services and peer reviews at
35	33		the point of care; and
36		-	(4) return-to-work best practices for workers'
	34	+	(4) return to work best practices for workers'
37	35		compensation claims, including complex case management.
38		-	(c) The workers' compensation ~~research and evaluation group~~
39		-	~~shall assist the office in identifying~~ and ~~adopting~~ measures for
	36	+	(c) The office shall work with the workers' compensation
	37	+	research and evaluation group to identify and adopt measures for
40	38		evaluating the demonstration program.
41	39		(d) The evaluation period for the demonstration program
42	40		shall end on June 30, 2020.
43		-	(e) If the office implements a demonstration program under
44		-	this section, not later than December 31, 2020, the office shall
	41	+	(e) Not later than December 31, 2020, the office shall
45	42		provide to the board a report that:
46	43		(1) evaluates the program, including any effects of
47	44		the program on administrative cost savings; and
48	45		(2) recommends whether to use the process implemented
49	46		under the program on a permanent basis.
50	47		(f) If the report of the demonstration program under
51	48		Subsection (e) indicates that administrative cost savings are
52	49		achieved by the process implemented under the program, the board
53	50		may adopt and use the process on a permanent basis.
54	51		(g) This section expires September 1, 2021.
55		-	SECTION 2. Not later than January 1, 2018, the State Office
56		-	of Risk Management shall make a determination as to whether the
57		-	demonstration program described by Section 412.0129, Labor Code, as
58		-	added by this Act, would be cost-effective. If the office
59		-	determines the program would be cost-effective and decides to
60		-	implement the program, the office shall fully implement the program
61		-	not later than January 1, 2019.
	52	+	SECTION 2. (a) Not later than January 1, 2018, the State
	53	+	Office of Risk Management shall begin developing the demonstration
	54	+	program under Section 412.0129, Labor Code, as added by this Act.
	55	+	(b) Not later than January 1, 2019, the State Office of Risk
	56	+	Management shall fully implement the demonstration program
	57	+	developed under Section 412.0129, Labor Code, as added by this Act.
62	58		SECTION 3. This Act takes effect immediately if it receives
63	59		a vote of two-thirds of all the members elected to each house, as
64	60		provided by Section 39, Article III, Texas Constitution. If this
65	61		Act does not receive the vote necessary for immediate effect, this
66	62		Act takes effect September 1, 2017.