Texas 2021 - 87th Regular

Texas House Bill HB1339 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	87R6779 JSC-F
2	2	By: Oliverson H.B. No. 1339
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to benefit review conferences and certain required reports
8	8	under the Texas workers' compensation system.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Section 1305.502(a), Insurance Code, is amended
11	11	to read as follows:
12	12	(a) Not later than December 1 of each even-numbered year,
13	13	the [The] group shall develop and issue an [annual] informational
14	14	report card that identifies and compares, on an objective basis,
15	15	the quality, costs, health care provider availability, and other
16	16	analogous factors of workers' compensation health care networks
17	17	operating under the workers' compensation system of this state with
18	18	each other and with medical care provided outside of networks.
19	19	SECTION 2. The heading to Section 410.005, Labor Code, is
20	20	amended to read as follows:
21	21	Sec. 410.005. CONDUCTING [VENUE FOR] ADMINISTRATIVE
22	22	PROCEEDINGS.
23	23	SECTION 3. Section 410.005, Labor Code, is amended by
24	24	amending Subsections (a) and (d) and adding Subsection (e) to read
25	25	as follows:
26	26	(a) Unless the division determines that good cause exists
27	27	for the selection of a different location, [a benefit review
28	28	conference or] a contested case hearing may not be conducted at a
29	29	site more than 75 miles from the claimant's residence at the time of
30	30	the injury.
31	31	(d) The [Notwithstanding Subsection (a), the] division may
32	32	conduct a benefit review conference:
33	33	(1) telephonically;
34	34	(2) by videoconference; or
35	35	(3) in person, on showing of good cause as determined
36	36	by the division [on agreement by the injured employee].
37	37	(e) Unless the division determines that good cause exists
38	38	for the selection of a different location, a benefit review
39	39	conference conducted in person under Subsection (d)(3) may not be
40	40	conducted at a site more than 75 miles from the claimant's residence
41	41	at the time of the injury.
42	42	SECTION 4. Sections 504.053(c) and (d), Labor Code, are
43	43	amended to read as follows:
44	44	(c) If the political subdivision or pool provides medical
45	45	benefits in the manner authorized under Subsection (b)(2), the
46	46	following do not apply:
47	47	(1) Sections 408.004 and 408.0041, unless use of a
48	48	required medical examination or designated doctor is necessary to
49	49	resolve an issue relating to the entitlement to or amount of income
50	50	benefits under this title;
51	51	(2) Subchapter B, Chapter 408, except for Section
52	52	408.021;
53	53	(3) Chapter 413, except for Section 413.042; and
54	54	(4) Chapter 1305, Insurance Code, except for Sections
55	55	[1305.501,] 1305.502[,] and 1305.503.
56	56	(d) If the political subdivision or pool provides medical
57	57	benefits in the manner authorized under Subsection (b)(2), the
58	58	following standards apply:
59	59	(1) the political subdivision or pool must ensure that
60	60	workers' compensation medical benefits are reasonably available to
61	61	all injured workers of the political subdivision or the injured
62	62	workers of the members of the pool within a designed service area;
63	63	(2) the political subdivision or pool must ensure that
64	64	all necessary health care services are provided in a manner that
65	65	will ensure the availability of and accessibility to adequate
66	66	health care providers, specialty care, and facilities;
67	67	(3) the political subdivision or pool must have an
68	68	internal review process for resolving complaints relating to the
69	69	manner of providing medical benefits, including an appeal to the
70	70	governing body or its designee and appeal to an independent review
71	71	organization;
72	72	(4) the political subdivision or pool must establish
73	73	reasonable procedures for the transition of injured workers to
74	74	contract providers and for the continuity of treatment, including
75	75	notice of impending termination of providers and a current list of
76	76	contract providers;
77	77	(5) the political subdivision or pool shall provide
78	78	for emergency care if an injured worker cannot reasonably reach a
79	79	contract provider and the care is for medical screening or other
80	80	evaluation that is necessary to determine whether a medical
81	81	emergency condition exists, necessary emergency care services
82	82	including treatment and stabilization, and services originating in
83	83	a hospital emergency facility following treatment or stabilization
84	84	of an emergency medical condition;
85	85	(6) prospective or concurrent review of the medical
86	86	necessity and appropriateness of health care services must comply
87	87	with Article 21.58A, Insurance Code;
88	88	(7) the political subdivision or pool shall continue
89	89	to report data to the appropriate agency as required by Title 5 of
90	90	this code and Chapter 1305, Insurance Code; and
91	91	(8) a political subdivision or pool is subject to the
92	92	requirements under Sections [1305.501,] 1305.502[,] and 1305.503,
93	93	Insurance Code.
94	94	SECTION 5. The following provisions are repealed:
95	95	(1) Section 1305.501, Insurance Code;
96	96	(2) Section 2053.012, Insurance Code; and
97	97	(3) Sections 405.0025(b) and (c), Labor Code.
98	98	SECTION 6. Section 410.005, Labor Code, as amended by this
99	99	Act, applies to a benefit review conference requested on or after
100	100	the effective date of this Act. A benefit review conference
101	101	requested before the effective date of this Act is governed by the
102	102	law in effect on the date the benefit review conference was
103	103	requested, and the former law is continued in effect for that
104	104	purpose.
105	105	SECTION 7. This Act takes effect immediately if it receives
106	106	a vote of two-thirds of all the members elected to each house, as
107	107	provided by Section 39, Article III, Texas Constitution. If this
108	108	Act does not receive the vote necessary for immediate effect, this
109	109	Act takes effect September 1, 2021.