Texas 2021 - 87th Regular

Texas House Bill HB1753 Latest Draft

Bill / Enrolled Version Filed 05/28/2021

                            H.B. No. 1753


 AN ACT
 relating to certain required reports under the Texas workers'
 compensation system.
 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 SECTION 1.  Section 1305.502(a), Insurance Code, is amended
 to read as follows:
 (a)  Not later than December 1 of each even-numbered year,
 the [The] group shall develop and issue an [annual] informational
 report card that identifies and compares, on an objective basis,
 the quality, costs, health care provider availability, and other
 analogous factors of workers' compensation health care networks
 operating under the workers' compensation system of this state with
 each other and with medical care provided outside of networks.
 SECTION 2.  Sections 504.053(c) and (d), Labor Code, are
 amended to read as follows:
 (c)  If the political subdivision or pool provides medical
 benefits in the manner authorized under Subsection (b)(2), the
 following do not apply:
 (1)  Sections 408.004 and 408.0041, unless use of a
 required medical examination or designated doctor is necessary to
 resolve an issue relating to the entitlement to or amount of income
 benefits under this title;
 (2)  Subchapter B, Chapter 408, except for Section
 408.021;
 (3)  Chapter 413, except for Section 413.042; and
 (4)  Chapter 1305, Insurance Code, except for Sections
 [1305.501,] 1305.502[,] and 1305.503.
 (d)  If the political subdivision or pool provides medical
 benefits in the manner authorized under Subsection (b)(2), the
 following standards apply:
 (1)  the political subdivision or pool must ensure that
 workers' compensation medical benefits are reasonably available to
 all injured workers of the political subdivision or the injured
 workers of the members of the pool within a designed service area;
 (2)  the political subdivision or pool must ensure that
 all necessary health care services are provided in a manner that
 will ensure the availability of and accessibility to adequate
 health care providers, specialty care, and facilities;
 (3)  the political subdivision or pool must have an
 internal review process for resolving complaints relating to the
 manner of providing medical benefits, including an appeal to the
 governing body or its designee and appeal to an independent review
 organization;
 (4)  the political subdivision or pool must establish
 reasonable procedures for the transition of injured workers to
 contract providers and for the continuity of treatment, including
 notice of impending termination of providers and a current list of
 contract providers;
 (5)  the political subdivision or pool shall provide
 for emergency care if an injured worker cannot reasonably reach a
 contract provider and the care is for medical screening or other
 evaluation that is necessary to determine whether a medical
 emergency condition exists, necessary emergency care services
 including treatment and stabilization, and services originating in
 a hospital emergency facility following treatment or stabilization
 of an emergency medical condition;
 (6)  prospective or concurrent review of the medical
 necessity and appropriateness of health care services must comply
 with Article 21.58A, Insurance Code;
 (7)  the political subdivision or pool shall continue
 to report data to the appropriate agency as required by Title 5 of
 this code and Chapter 1305, Insurance Code; and
 (8)  a political subdivision or pool is subject to the
 requirements under Sections [1305.501,] 1305.502[,] and 1305.503,
 Insurance Code.
 SECTION 3.  The following provisions are repealed:
 (1)  Section 1305.501, Insurance Code;
 (2)  Section 2053.012, Insurance Code; and
 (3)  Sections 405.0025(b) and (c), Labor Code.
 SECTION 4.  This Act takes effect immediately if it receives
 a vote of two-thirds of all the members elected to each house, as
 provided by Section 39, Article III, Texas Constitution.  If this
 Act does not receive the vote necessary for immediate effect, this
 Act takes effect September 1, 2021.
 ______________________________ ______________________________
 President of the Senate Speaker of the House
 I certify that H.B. No. 1753 was passed by the House on May 7,
 2021, by the following vote:  Yeas 143, Nays 0, 1 present, not
 voting.
 ______________________________
 Chief Clerk of the House
 I certify that H.B. No. 1753 was passed by the Senate on May
 26, 2021, by the following vote:  Yeas 31, Nays 0.
 ______________________________
 Secretary of the Senate
 APPROVED:  _____________________
 Date
 _____________________
 Governor