By: Zaffirini S.B. No. 1494
(In the Senate - Filed March 8, 2017; March 20, 2017, read
first time and referred to Committee on Business & Commerce;
April 12, 2017, reported favorably by the following vote: Yeas 9,
Nays 0; April 12, 2017, sent to printer.)
Click here to see the committee vote
A BILL TO BE ENTITLED
AN ACT
relating to preauthorization and concurrent review of certain
health care services under the workers' compensation system.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 413.014, Labor Code, is amended by
amending Subsection (c) and adding Subsection (c-1) to read as
follows:
(c) The commissioner's rules adopted under this section
must provide that preauthorization and concurrent review are
required at a minimum for:
(1) spinal surgery, as provided by Section 408.026;
(2) work-hardening or work-conditioning services
[provided by a health care facility that is not credentialed by an
organization recognized by commissioner rules];
(3) inpatient hospitalization, including any
procedure and length of stay;
(4) physical and occupational therapy;
(5) outpatient or ambulatory surgical services, as
defined by commissioner rule; and
(6) any investigational or experimental services or
devices.
(c-1) Notwithstanding Subsection (c)(2), the commissioner
by rule may exempt from preauthorization and concurrent review
work-hardening or work-conditioning services provided by a health
care facility that is credentialed by an organization designated by
commissioner rule.
SECTION 2. The change in law made by this Act applies only
to health care services provided on or after the effective date of
this Act in conjunction with a claim for workers' compensation
benefits, regardless of the date on which the compensable injury
that is the basis of the claim occurred.
SECTION 3. This Act takes effect September 1, 2017.
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