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House Bill 724 |
House Author: Solomons |
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Effective: 9-1-07 |
Senate Sponsor: Jackson, Mike |
Legislation enacted during the 79th Legislature, Regular Session, 2005, that made comprehensive changes to the state's workers' compensation laws eliminated provisions allowing a party to a medical fee dispute to appeal the decision of the agency overseeing the workers' compensation industry to the State Office of Administrative Hearings (SOAH). In 2006, a state district court ruled the omission of that option unconstitutional. House Bill 724 amends the Labor Code to reestablish an appeal process for such disputes. The bill allows a party to a dispute other than certain disputes relating to spinal surgery to request that an administrative hearing be conducted by SOAH if an unpaid, disputed portion of a fee is more than $2,000 or if a service deemed necessary by an independent review organization is more than $3,000; other disputes may be appealed to a contested case hearing conducted by the Division of Workers' Compensation (DWC) at the Texas Department of Insurance. The bill requires a hearing for a dispute appealed to SOAH to be conducted within 60 days after the request is made and allows a party to appeal a SOAH or DWC decision directly to judicial review.
In addition, House Bill 724 allows a surviving parent, under certain conditions, to be eligible for death benefits in a workers' compensation case for a benefit period not to exceed two years. The bill establishes procedures for a health care insurer to be reimbursed for workers' compensation health care services and allows reimbursement to an accident or health insurance carrier of costs it paid for services in connection with a workers' compensation injury.