Texas 2017 - 85th Regular

Texas Senate Bill SB1493 Compare Versions

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Version 2 (New)

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	1	+	85R5415 KKR-F
1	2		By: Zaffirini S.B. No. 1493
2		-	(In the Senate - Filed March 8, 2017; March 20, 2017, read
3		-	first time and referred to Committee on Business & Commerce;
4		-	April 18, 2017, reported favorably by the following vote: Yeas 9,
5		-	Nays 0; April 18, 2017, sent to printer.)
6		-	Click here to see the committee vote
7	3
8	4
9	5		A BILL TO BE ENTITLED
10	6		AN ACT
11	7		relating to changing statutory references to hearing officer and
12	8		hearings officer to administrative law judge under the workers'
13	9		compensation system.
14	10		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
15	11		SECTION 1. Section 1305.356(b), Insurance Code, is amended
16	12		to read as follows:
17	13		(b) At a contested case hearing held under Subsection (a),
18	14		the administrative law judge [hearing officer] conducting the
19	15		hearing shall consider evidence-based treatment guidelines adopted
20	16		by the network under Section 1305.304.
21	17		SECTION 2. Section 409.0091(m), Labor Code, is amended to
22	18		read as follows:
23	19		(m) In a dispute filed under Chapter 410 that arises from a
24	20		subclaim under this section, an administrative law judge [a hearing
25	21		officer] may issue an order regarding compensability or eligibility
26	22		for benefits and order the workers' compensation insurance carrier
27	23		to reimburse health care services paid by the health care insurer as
28	24		appropriate under this subtitle. Any dispute over the amount of
29	25		medical benefits owed under this section, including medical
30	26		necessity issues, shall be determined by medical dispute resolution
31	27		under Sections 413.031 and 413.032.
32	28		SECTION 3. Section 410.152, Labor Code, is amended to read
33	29		as follows:
34	30		Sec. 410.152. ADMINISTRATIVE LAW JUDGES [HEARING
35	31		OFFICERS]; QUALIFICATIONS. (a) An administrative law judge [A
36	32		hearing officer] shall conduct a contested case hearing.
37	33		(b) An administrative law judge [A hearing officer] must be
38	34		licensed to practice law in this state.
39	35		SECTION 4. Section 410.156(b), Labor Code, is amended to
40	36		read as follows:
41	37		(b) A party commits an administrative violation if the
42	38		party, without good cause as determined by the administrative law
43	39		judge [hearing officer], does not attend a contested case hearing.
44	40		SECTION 5. Section 410.158(a), Labor Code, is amended to
45	41		read as follows:
46	42		(a) Except as provided by Section 410.162, discovery is
47	43		limited to:
48	44		(1) depositions on written questions to any health
49	45		care provider;
50	46		(2) depositions of other witnesses as permitted by the
51	47		administrative law judge [hearing officer] for good cause shown;
52	48		and
53	49		(3) interrogatories as prescribed by the
54	50		commissioner.
55	51		SECTION 6. Section 410.162, Labor Code, is amended to read
56	52		as follows:
57	53		Sec. 410.162. ADDITIONAL DISCOVERY. For good cause shown,
58	54		a party may obtain permission from the administrative law judge
59	55		[hearing officer] to conduct additional discovery as necessary.
60	56		SECTION 7. Section 410.163, Labor Code, is amended to read
61	57		as follows:
62	58		Sec. 410.163. POWERS AND DUTIES OF ADMINISTRATIVE LAW JUDGE
63	59		[HEARING OFFICER]. (a) At a contested case hearing the
64	60		administrative law judge [hearing officer] shall:
65	61		(1) swear witnesses;
66	62		(2) receive testimony;
67	63		(3) allow examination and cross-examination of
68	64		witnesses;
69	65		(4) accept documents and other tangible evidence; and
70	66		(5) allow the presentation of evidence by affidavit.
71	67		(b) An administrative law judge [A hearing officer] shall
72	68		ensure the preservation of the rights of the parties and the full
73	69		development of facts required for the determinations to be made. An
74	70		administrative law judge [A hearing officer] may permit the use of
75	71		summary procedures, if appropriate, including witness statements,
76	72		summaries, and similar measures to expedite the proceedings.
77	73		SECTION 8. Section 410.164(c), Labor Code, is amended to
78	74		read as follows:
79	75		(c) At each contested case hearing, as applicable, the
80	76		insurance carrier shall file with the administrative law judge
81	77		[hearing officer] and shall deliver to the claimant a single
82	78		document stating the true corporate name of the insurance carrier
83	79		and the name and address of the insurance carrier's registered
84	80		agent for service of process. The document is part of the record of
85	81		the contested case hearing.
86	82		SECTION 9. Section 410.165, Labor Code, is amended to read
87	83		as follows:
88	84		Sec. 410.165. EVIDENCE. (a) The administrative law judge
89	85		[hearing officer] is the sole judge of the relevance and
90	86		materiality of the evidence offered and of the weight and
91	87		credibility to be given to the evidence. Conformity to legal rules
92	88		of evidence is not necessary.
93	89		(b) An administrative law judge [A hearing officer] may
94	90		accept a written statement signed by a witness and shall accept all
95	91		written reports signed by a health care provider.
96	92		SECTION 10. Section 410.167, Labor Code, is amended to read
97	93		as follows:
98	94		Sec. 410.167. EX PARTE CONTACTS PROHIBITED. A party and an
99	95		administrative law judge [a hearing officer] may not communicate
100	96		outside the contested case hearing unless the communication is in
101	97		writing with copies provided to all parties or relates to
102	98		procedural matters.
103	99		SECTION 11. Sections 410.168(a), (c), (d), and (e), Labor
104	100		Code, are amended to read as follows:
105	101		(a) The administrative law judge [hearing officer] shall
106	102		issue a written decision that includes:
107	103		(1) findings of fact and conclusions of law;
108	104		(2) a determination of whether benefits are due; and
109	105		(3) an award of benefits due.
110	106		(c) The administrative law judge [hearing officer] may
111	107		enter an interlocutory order for the payment of all or part of
112	108		medical benefits or income benefits. The order may address accrued
113	109		benefits, future benefits, or both accrued benefits and future
114	110		benefits. The order is binding during the pendency of an appeal to
115	111		the appeals panel.
116	112		(d) On a form that the commissioner by rule prescribes, the
117	113		administrative law judge [hearing officer] shall issue a separate
118	114		written decision regarding attorney's fees and any matter related
119	115		to attorney's fees. The decision regarding attorney's fees and the
120	116		form may not be made known to a jury in a judicial review of an
121	117		award, including an appeal.
122	118		(e) The commissioner by rule shall prescribe the times
123	119		within which the administrative law judge [hearing officer] must
124	120		file the decisions with the division.
125	121		SECTION 12. Section 410.169, Labor Code, is amended to read
126	122		as follows:
127	123		Sec. 410.169. EFFECT OF DECISION. A decision of an
128	124		administrative law judge [a hearing officer] regarding benefits is
129	125		final in the absence of a timely appeal by a party and is binding
130	126		during the pendency of an appeal to the appeals panel.
131	127		SECTION 13. Sections 410.202(a) and (c), Labor Code, are
132	128		amended to read as follows:
133	129		(a) To appeal the decision of an administrative law judge [a
134	130		hearing officer], a party shall file a written request for appeal
135	131		with the appeals panel not later than the 15th day after the date on
136	132		which the decision of the administrative law judge [hearing
137	133		officer] is received from the division and shall on the same date
138	134		serve a copy of the request for appeal on the other party.
139	135		(c) A request for appeal or a response must clearly and
140	136		concisely rebut or support the decision of the administrative law
141	137		judge [hearing officer] on each issue on which review is sought.
142	138		SECTION 14. Section 410.203(b), Labor Code, is amended to
143	139		read as follows:
144	140		(b) The appeals panel may:
145	141		(1) reverse the decision of the administrative law
146	142		judge [hearings officer] and render a new decision;
147	143		(2) reverse the decision of the administrative law
148	144		judge [hearings officer] and remand the case to the administrative
149	145		law judge [hearing officer] for further consideration and
150	146		development of evidence; or
151	147		(3) affirm the decision of the administrative law
152	148		judge [hearings officer] in a case described by Section
153	149		410.204(a-1).
154	150		SECTION 15. Sections 410.204(a-1) and (c), Labor Code, are
155	151		amended to read as follows:
156	152		(a-1) An appeals panel may only issue a written decision in
157	153		a case in which the panel affirms the decision of an administrative
158	154		law judge [a hearings officer] if the case:
159	155		(1) is a case of first impression;
160	156		(2) involves a recent change in law; or
161	157		(3) involves errors at the contested case hearing that
162	158		require correction but do not affect the outcome of the hearing,
163	159		including:
164	160		(A) findings of fact for which insufficient
165	161		evidence exists;
166	162		(B) incorrect conclusions of law;
167	163		(C) findings of fact or conclusions of law
168	164		regarding matters that were not properly before the administrative
169	165		law judge [hearings officer]; and
170	166		(D) legal errors not otherwise described by this
171	167		subdivision.
172	168		(c) If the appeals panel does not issue a decision in
173	169		accordance with this section, the decision of the administrative
174	170		law judge [hearing officer] becomes final and is the final decision
175	171		of the appeals panel.
176	172		SECTION 16. Sections 413.0311(b), (c), and (d), Labor Code,
177	173		are amended to read as follows:
178	174		(b) A party to a medical dispute described by Subsection (a)
179	175		is entitled to a contested case hearing. A contested case hearing
180	176		under this section shall be conducted by an administrative law
181	177		judge [a hearings officer] in the manner provided for contested
182	178		case hearings under Subchapter D, Chapter 410. Notwithstanding
183	179		Section 410.024, a benefit review conference is not a prerequisite
184	180		to a contested case hearing under this section.
185	181		(c) The decision of an administrative law judge [a hearings
186	182		officer] under this section is final in the absence of a timely
187	183		appeal by a party for judicial review under Subsection (d).
188	184		(d) A party who has exhausted all administrative remedies
189	185		under Section 413.031 and this section and who is aggrieved by a
190	186		final decision of the administrative law judge [hearings officer]
191	187		under Subsection (c) may seek judicial review of the decision.
192	188		Judicial review under this subsection shall be conducted in the
193	189		manner provided for judicial review of a contested case under
194	190		Subchapter G, Chapter 2001, Government Code, except that the party
195	191		seeking judicial review under this section must file suit not later
196	192		than the 45th day after the date on which the division mailed the
197	193		party the decision of the administrative law judge [hearings
198	194		officer]. For purposes of this subsection, the mailing date is
199	195		considered to be the fifth day after the date the decision of the
200	196		administrative law judge [hearings officer] was filed with the
201	197		division.
202	198		SECTION 17. Section 504.054(b), Labor Code, is amended to
203	199		read as follows:
204	200		(b) The administrative law judge [hearing officer]
205	201		conducting the contested case hearing under Subsection (a) shall
206	202		consider any treatment guidelines adopted by the political
207	203		subdivision or pool that provides medical benefits under Section
208	204		504.053(b)(2) if those guidelines meet the standards provided by
209	205		Section 413.011(e).
210	206		SECTION 18. This Act takes effect September 1, 2017.
211		-	* * * * *