| 1 | 1 | | 86R8386 KKR-F |
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| 2 | 2 | | By: Murphy H.B. No. 4300 |
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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 a settlement for the payment of certain medical |
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| 8 | 8 | | benefits under the Texas Workers' Compensation Act. |
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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 408.005, Labor Code, is amended by |
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| 11 | 11 | | amending Subsections (b) and (e) and adding Subsections (b-1) and |
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| 12 | 12 | | (e-1) to read as follows: |
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| 13 | 13 | | (b) An employee's right to medical benefits as provided by |
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| 14 | 14 | | Section 408.021 may not be limited or terminated except as provided |
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| 15 | 15 | | by this section. |
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| 16 | 16 | | (b-1) Parties may reach a settlement of medical benefits if: |
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| 17 | 17 | | (1) the injured employee enters into a workers' |
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| 18 | 18 | | compensation Medicare set-aside arrangement; |
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| 19 | 19 | | (2) the arrangement described by Subdivision (1) is |
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| 20 | 20 | | approved by the federal Centers for Medicare and Medicaid Services, |
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| 21 | 21 | | if the proposed amount of the settlement is eligible for review by |
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| 22 | 22 | | that agency; and |
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| 23 | 23 | | (3) the settlement provides for: |
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| 24 | 24 | | (A) oversight of the arrangement described by |
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| 25 | 25 | | Subdivision (1) by a corporate trustee or other professional |
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| 26 | 26 | | administrator; and |
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| 27 | 27 | | (B) a reversionary interest on the employee's |
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| 28 | 28 | | death allowing the unexpended funds to be shared by the injured |
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| 29 | 29 | | employee's beneficiary and the payor. |
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| 30 | 30 | | (e) The commissioner shall approve a settlement if the |
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| 31 | 31 | | commissioner is satisfied that: |
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| 32 | 32 | | (1) the settlement accurately reflects the agreement |
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| 33 | 33 | | between the parties; |
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| 34 | 34 | | (2) the settlement reflects adherence to all |
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| 35 | 35 | | appropriate provisions of law and the rules [policies] of the |
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| 36 | 36 | | division; [and] |
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| 37 | 37 | | (3) under the law and facts, the settlement is in the |
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| 38 | 38 | | best interest of the injured employee; |
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| 39 | 39 | | (4) the settlement is entered into voluntarily by all |
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| 40 | 40 | | parties; and |
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| 41 | 41 | | (5) to the extent possible, all extent of injury |
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| 42 | 42 | | issues have been resolved [claimant]. |
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| 43 | 43 | | (e-1) For purposes of Subsection (e)(3), the commissioner |
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| 44 | 44 | | may not find that a settlement of medical benefits under Subsection |
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| 45 | 45 | | (b-1) is in the best interest of the injured employee unless the |
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| 46 | 46 | | settlement is overseen by a corporate trustee or other professional |
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| 47 | 47 | | administrator. |
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| 48 | 48 | | SECTION 2. Section 408.021(d), Labor Code, is amended to |
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| 49 | 49 | | read as follows: |
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| 50 | 50 | | (d) Except as provided by Section 408.005, an [An] insurance |
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| 51 | 51 | | carrier's liability for medical benefits may not be limited or |
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| 52 | 52 | | terminated by agreement or settlement. |
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| 53 | 53 | | SECTION 3. The change in law made by this Act applies only |
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| 54 | 54 | | to a settlement entered into on or after the effective date of this |
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| 55 | 55 | | Act, in conjunction with a claim for workers' compensation |
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| 56 | 56 | | benefits, regardless of the date on which the compensable injury |
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| 57 | 57 | | that is the basis of the claim occurred. |
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| 58 | 58 | | SECTION 4. This Act takes effect September 1, 2019. |
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