H.B. No. 1089
    1-1                                AN ACT
    1-2  relating to the continuation and functions of the Texas Workers'
    1-3  Compensation Commission; providing penalties.
    1-4        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
    1-5          ARTICLE 1.  TEXAS WORKERS' COMPENSATION COMMISSION
    1-6        SECTION 1.01.  Section 401.002, Labor Code, is amended to
    1-7  read as follows:
    1-8        Sec. 401.002.  APPLICATION OF SUNSET ACT.  The Texas Workers'
    1-9  Compensation Commission is <and the Texas Workers' Compensation
   1-10  Research Center are> subject to Chapter 325, Government Code (Texas
   1-11  Sunset Act).  Unless continued in existence as provided by that
   1-12  chapter, the commission is abolished September 1, 2007 <1995, and
   1-13  the research center and the legislative oversight committee are
   1-14  abolished September 1, 1995>.
   1-15        SECTION 1.02.  Section 402.001(c), Labor Code, is amended to
   1-16  read as follows:
   1-17        (c)  Three members of the commission must be employers of
   1-18  labor and three members of the commission must be wage earners.  A
   1-19  person is not eligible for appointment as a member of the
   1-20  commission if the person provides services subject to regulation by
   1-21  the commission or charges fees that are subject to regulation by
   1-22  the commission.
   1-23        SECTION 1.03.  Subchapter A, Chapter 402, Labor Code, is
   1-24  amended by adding Section 402.0015 to read as follows:
    2-1        Sec. 402.0015.  TRAINING PROGRAM FOR COMMISSION MEMBERS.  (a)
    2-2  Before a member of the commission may assume the member's duties,
    2-3  the member must complete the training program established under
    2-4  this section.
    2-5        (b)  A training program established under this section must
    2-6  provide information to the member regarding:
    2-7              (1)  the enabling legislation that created the
    2-8  commission;
    2-9              (2)  the programs operated by the commission;
   2-10              (3)  the role and functions of the commission;
   2-11              (4)  the rules of the commission, with an emphasis on
   2-12  the rules that relate to disciplinary and investigatory authority;
   2-13              (5)  the current budget for the commission;
   2-14              (6)  the results of the most recent formal audit of the
   2-15  commission;
   2-16              (7)  the requirements of:
   2-17                    (A)  the open meetings law, Chapter 551,
   2-18  Government Code;
   2-19                    (B)  the open records law, Chapter 552,
   2-20  Government Code; and
   2-21                    (C)  the administrative procedure law, Chapter
   2-22  2001, Government Code;
   2-23              (8)  the requirements of the conflict of interest laws
   2-24  and other laws relating to public officials; and
   2-25              (9)  any applicable ethics policies adopted by the
   2-26  commission or the Texas Ethics Commission.
   2-27        SECTION 1.04.  Section 402.003, Labor Code, is amended to
    3-1  read as follows:
    3-2        Sec. 402.003.  EFFECT OF LOBBYING ACTIVITY.  A person may not
    3-3  serve as a member of the commission or act as the general counsel
    3-4  to the commission if the person is required to register as a
    3-5  lobbyist under Chapter 305, Government Code, because of the
    3-6  person's activities for compensation on behalf of a profession that
    3-7  is regulated by or that has fees regulated by the commission <A
    3-8  member of the commission may not be a lobbyist required to be
    3-9  registered under Chapter 305, Government Code, if the primary
   3-10  purpose of the person's employment is to influence the passage of
   3-11  legislation>.
   3-12        SECTION 1.05.  Sections 402.005(a) and (c), Labor Code, are
   3-13  amended to read as follows:
   3-14        (a)  It is a ground for removal from the commission if <that>
   3-15  a member:
   3-16              (1)  does not have at the time of appointment the
   3-17  qualifications required for appointment to the commission;
   3-18              (2)  does not maintain during service on the commission
   3-19  the qualifications required for appointment to the commission;
   3-20              (3)  violates a prohibition established by Section
   3-21  402.003 or 402.012;
   3-22              (4)  cannot <discharge> because of illness or
   3-23  incapacity discharge the member's duties for a substantial part of
   3-24  the term for which the member is appointed; or
   3-25              (5) <(4)>  is absent from more than half of the
   3-26  regularly scheduled commission meetings that the member is eligible
   3-27  to attend during a calendar year <unless the absence is excused by
    4-1  a majority vote of the commission>.
    4-2        (c)  If the executive director of the commission knows that a
    4-3  potential ground for removal exists, the executive director shall
    4-4  notify the chairman of the commission of the potential ground.  The
    4-5  chairman shall then notify the governor and the attorney general
    4-6  that a potential ground for removal exists.  If the potential
    4-7  ground for removal involves the chairman, the executive director
    4-8  shall notify the next highest officer of the commission, who shall
    4-9  notify the governor and the attorney general that a potential
   4-10  ground for removal exists.
   4-11        SECTION 1.06.  Section 402.008(a), Labor Code, is amended to
   4-12  read as follows:
   4-13        (a)  The governor shall designate a member of the commission
   4-14  as the chairman of the commission <The commission shall elect one
   4-15  of its members> to serve in that capacity <as chairman> for a
   4-16  two-year term expiring February 1 of each odd-numbered year.  The
   4-17  governor shall alternate the chairmanship between the members who
   4-18  are employers and the members who are wage earners.
   4-19        SECTION 1.07.  Subchapter A, Chapter 402, Labor Code, is
   4-20  amended by adding Section 402.012 to read as follows:
   4-21        Sec. 402.012.  CONFLICT OF INTEREST.  (a)  An officer,
   4-22  employee, or paid consultant of a Texas trade association whose
   4-23  members provide services subject to regulation by the commission or
   4-24  provide services whose fees are subject to regulation by the
   4-25  commission may not be a member of the commission or an employee of
   4-26  the commission who is exempt from the state's position
   4-27  classification plan or is compensated at or above the amount
    5-1  prescribed by the General Appropriations Act for step 1, salary
    5-2  group 17, of the position classification salary schedule.
    5-3        (b)  On acceptance of appointment to the commission, an
    5-4  appointee who is an officer, employee, or paid consultant of a
    5-5  Texas trade association described by Subsection (a) must resign the
    5-6  position or terminate the contract with the trade association.
    5-7        (c)  For the purposes of this section, "Texas trade
    5-8  association" means a nonprofit, cooperative, and voluntarily joined
    5-9  association of business or professional competitors in this state
   5-10  designed to assist its members and its industry or profession in
   5-11  dealing with mutual business or professional problems and in
   5-12  promoting their common interest.  The term does not include a labor
   5-13  union or an employees' association.
   5-14        SECTION 1.08.  Section 402.023, Labor Code, is amended to
   5-15  read as follows:
   5-16        Sec. 402.023.  COMPLAINT INFORMATION.  (a)  The executive
   5-17  director shall keep an information file about each written
   5-18  complaint filed with the commission that is unrelated to a specific
   5-19  workers' compensation claim.  The information must include:
   5-20              (1)  the date the complaint is received;
   5-21              (2)  the name of the complainant;
   5-22              (3)  the subject matter of the complaint;
   5-23              (4)  a record of all persons contacted in relation to
   5-24  the complaint;
   5-25              (5)  a summary of the results of the review or
   5-26  investigation of the complaint; and
   5-27              (6)  for complaints for which the commission took no
    6-1  action, an explanation of the reason the complaint was closed
    6-2  without action.
    6-3        (b)  For each written <The commission shall notify the
    6-4  parties to a> complaint that is unrelated to a specific workers'
    6-5  compensation claim that the commission has authority to resolve,
    6-6  the executive director shall provide to the person filing the
    6-7  complaint and the person about whom the complaint is made
    6-8  information about the commission's policies and procedures relating
    6-9  to complaint investigation and resolution.  The commission, <of the
   6-10  status of the complaint> at least quarterly and until final
   6-11  disposition of the complaint, shall notify those persons about the
   6-12  status of the complaint unless the notice would jeopardize an
   6-13  undercover investigation.
   6-14        SECTION 1.09.  Section 402.024, Labor Code, is amended to
   6-15  read as follows:
   6-16        Sec. 402.024.  PUBLIC PARTICIPATION.  (a)  The commission
   6-17  shall develop and implement policies that provide the public with a
   6-18  reasonable opportunity to appear before the commission and to speak
   6-19  on issues under the general jurisdiction of the commission.
   6-20        (b)  The commission shall comply with federal and state laws
   6-21  related to program and facility accessibility.
   6-22        (c)  In addition to compliance with Subsection (a), the
   6-23  <The> executive director shall prepare and maintain a written plan
   6-24  that describes how a person who does not speak English <or who has
   6-25  a physical, mental, or developmental disability> may be provided
   6-26  reasonable access to the commission's programs and services
   6-27  <workers' compensation proceedings>.
    7-1        <(c)  Section 401.011(16) does not apply to the use of
    7-2  "disability" in Subsection (b).>
    7-3        SECTION 1.10.  Section 402.041, Labor Code, is amended by
    7-4  adding Subsection (d) to read as follows:
    7-5        (d)  The commission shall develop and implement policies that
    7-6  clearly separate the policymaking responsibilities of the
    7-7  commission and the management responsibilities of the executive
    7-8  director and the staff of the commission.
    7-9        SECTION 1.11.  Section 402.044, Labor Code, is amended to
   7-10  read as follows:
   7-11        Sec. 402.044.  CAREER LADDER; ANNUAL PERFORMANCE EVALUATIONS.
   7-12  (a)  The executive director shall develop an intra-agency career
   7-13  ladder program that addresses opportunities for mobility and
   7-14  advancement for employees within the commission.  The program shall
   7-15  require intra-agency postings of all <nonentry level> positions
   7-16  concurrently with any public posting.
   7-17        (b)  The executive director shall develop a system of annual
   7-18  performance evaluations that are based on documented employee
   7-19  performance.  All merit pay for commission employees must be based
   7-20  on the system established under this subsection.
   7-21        SECTION 1.12.  Section 402.045, Labor Code, is amended to
   7-22  read as follows:
   7-23        Sec. 402.045.  EQUAL EMPLOYMENT OPPORTUNITY POLICY STATEMENT.
   7-24  (a)  The executive director shall prepare and maintain a written
   7-25  policy statement <approved by the commission> to ensure
   7-26  implementation of a program of equal employment opportunity under
   7-27  which all personnel transactions are made without regard to race,
    8-1  color, disability, sex, religion, age, or national origin.  The
    8-2  policy statement must include:
    8-3              (1)  personnel policies, including policies related to
    8-4  recruitment, evaluation, selection, appointment, training, and
    8-5  promotion of personnel that are in compliance with the requirements
    8-6  of Chapter 21;
    8-7              (2)  a comprehensive analysis of the commission work
    8-8  force that meets federal and state guidelines <of the commission's
    8-9  work force>;
   8-10              (3)  procedures by which a determination can be made of
   8-11  significant underuse in the commission <commission's> work force of
   8-12  all persons for whom federal or state guidelines encourage a more
   8-13  equitable balance; and
   8-14              (4)  reasonable methods to appropriately address those
   8-15  areas of <significant> underuse <appropriately>.
   8-16        (b)  A policy statement prepared under this section must:
   8-17              (1)  cover an annual period;
   8-18              (2)  be updated <at least> annually; <and>
   8-19              (3)  be reviewed by the Commission on Human Rights for
   8-20  compliance with Subsection (a)(1); and
   8-21              (4)  be filed with the governor's office.
   8-22        (c)  The governor's office shall deliver a biennial report to
   8-23  the legislature based on the information received under Subsection
   8-24  (b) <this section>.  The report may be made separately or as part
   8-25  of other biennial reports made to the legislature.
   8-26        SECTION 1.13.  Subchapter D, Chapter 402, Labor Code, is
   8-27  amended by adding Section 402.0665 to read as follows:
    9-1        Sec. 402.0665.  LEGISLATIVE OVERSIGHT.  The legislature may
    9-2  adopt requirements relating to legislative oversight of the
    9-3  commission and the workers' compensation system of this state.  The
    9-4  commission shall comply with any requirements adopted by the
    9-5  legislature under this section.
    9-6        SECTION 1.14.  Section 402.068, Labor Code, is amended to
    9-7  read as follows:
    9-8        Sec. 402.068.  DELEGATION OF RIGHTS AND DUTIES <PROHIBITED>.
    9-9  Except as expressly provided by this subchapter <Section 402.065>,
   9-10  the commission may not delegate rights and duties imposed on it by
   9-11  this subchapter.
   9-12        SECTION 1.15.  Section 402.069, Labor Code, is amended to
   9-13  read as follows:
   9-14        Sec. 402.069.  QUALIFICATIONS AND STANDARDS OF CONDUCT
   9-15  INFORMATION.  The executive director <commission> shall provide to
   9-16  <its> members of the commission and commission employees, as often
   9-17  as necessary, information regarding their:
   9-18              (1)  qualifications for office or employment under this
   9-19  subtitle; and
   9-20              (2)  responsibilities under applicable law relating to
   9-21  standards of conduct for state officers or employees.
   9-22        SECTION 1.16.  Section 402.070, Labor Code, is amended to
   9-23  read as follows:
   9-24        Sec. 402.070.  ANNUAL REPORT.  (a)  The commission shall
   9-25  prepare <file> annually <with the governor and the presiding
   9-26  officer of each house of the legislature> a complete and detailed
   9-27  written report accounting for all funds received and disbursed by
   10-1  the commission during the preceding fiscal year.
   10-2        (b)  The report required under this section must meet the
   10-3  reporting requirements applicable to financial reporting that are
   10-4  <be in the form and reported in the time> provided by the General
   10-5  Appropriations Act.
   10-6        SECTION 1.17.  Subchapter D, Chapter 402, Labor Code, is
   10-7  amended by adding Section 402.073 to read as follows:
   10-8        Sec. 402.073.  COOPERATION WITH STATE OFFICE OF
   10-9  ADMINISTRATIVE HEARINGS.  (a)  The commission and the chief
  10-10  administrative law judge of the State Office of Administrative
  10-11  Hearings by rule shall adopt a memorandum of understanding
  10-12  governing administrative procedure law hearings under this subtitle
  10-13  conducted by the State Office of Administrative Hearings in the
  10-14  manner provided for a contested case hearing under Chapter 2001,
  10-15  Government Code (the administrative procedure law).
  10-16        (b)  In a case in which a hearing is conducted by the State
  10-17  Office of Administrative Hearings under Section 411.049, 413.031,
  10-18  or 415.034, the administrative law judge who conducts the hearing
  10-19  for the State Office of Administrative Hearings shall enter the
  10-20  final decision in the case after completion of the hearing.
  10-21        (c)  In a case in which a hearing is conducted in conjunction
  10-22  with Section 402.072, 407.046, or 408.023, and in other cases under
  10-23  this subtitle that are not subject to Subsection (b), the
  10-24  administrative law judge who conducts the hearing for the State
  10-25  Office of Administrative Hearings shall propose a decision to the
  10-26  commission for final consideration and decision by the commission.
  10-27        SECTION 1.18.  Section 402.091(d), Labor Code, is amended to
   11-1  read as follows:
   11-2        (d)  An offense under this section may be prosecuted in a
   11-3  court in<:>
   11-4              <(1)  Travis County; or>
   11-5              <(2)>  the county where the information was unlawfully
   11-6  received, published, disclosed, or distributed.
   11-7        SECTION 1.19.   Subchapter E, Chapter 402, Labor Code, is
   11-8  amended by adding Section 402.092 to read as follows:
   11-9        Sec. 402.092.  INVESTIGATION FILES CONFIDENTIAL.  (a)
  11-10  Information maintained in the investigation files of the commission
  11-11  is confidential and may not be disclosed except:
  11-12              (1)  in a criminal proceeding;
  11-13              (2)  in a hearing conducted by the commission;
  11-14              (3)  on a judicial determination of good cause; or
  11-15              (4)  to a governmental agency, political subdivision,
  11-16  or regulatory body if the disclosure is necessary or proper for the
  11-17  enforcement of the laws of this or another state or of the United
  11-18  States.
  11-19        (b)  Commission investigation files are not open records for
  11-20  purposes of Chapter 552, Government Code.
  11-21        (c)  Information in an investigation file that is information
  11-22  in or derived from a claim file, or an employer injury report or
  11-23  occupational disease report, is governed by the confidentiality
  11-24  provisions relating to that information.
  11-25        (d)  For purposes of this section, "investigation file" means
  11-26  any information compiled or maintained by the commission with
  11-27  respect to a commission investigation authorized by law.
   12-1        (e)  The commission, upon request, shall disclose the
   12-2  identity of a complainant under this section if the commission
   12-3  finds:
   12-4              (1)  the complaint was groundless or made in bad faith;
   12-5  or
   12-6              (2)  the complaint lacks any basis in fact or evidence;
   12-7  or
   12-8              (3)  the complaint is frivolous; or
   12-9              (4)  the complaint is done specifically for competitive
  12-10  or economic advantage.
  12-11        (f)  Upon completion of an investigation where the commission
  12-12  determines a complaint is groundless, frivolous, made in bad faith,
  12-13  or is not supported by evidence or is done specifically for
  12-14  competitive or economic advantage the commission shall notify the
  12-15  person who was the subject of the complaint of its finding and the
  12-16  identity of the complainant.
  12-17        SECTION 1.20.  Subchapter E, Chapter 406, Labor Code, is
  12-18  amended by adding Section 406.097 to read as follows:
  12-19        Sec. 406.097.  EXECUTIVE EMPLOYEES OF CERTAIN BUSINESS
  12-20  ENTITIES.  (a)  A sole proprietor, partner, or corporate executive
  12-21  officer of a business entity that elects to provide workers'
  12-22  compensation insurance coverage is entitled to benefits under that
  12-23  coverage as an employee unless the sole proprietor, partner, or
  12-24  corporate executive officer is specifically excluded from coverage
  12-25  through an endorsement to the insurance policy or certificate of
  12-26  authority to self-insure.
  12-27        (b)  The dual capacity doctrine does not apply to a corporate
   13-1  executive officer with an equity ownership in the covered business
   13-2  entity of at least 25 percent and will not invalidate the exclusion
   13-3  of such a corporate executive officer from coverage under
   13-4  Subsection (a).
   13-5        (c)  A sole proprietor or partner of a covered business
   13-6  entity or a corporate officer with an equity ownership in a covered
   13-7  business entity of at least 25 percent may be excluded from
   13-8  coverage under this section notwithstanding Section 406.096.
   13-9        SECTION 1.21.  Sections 407.046(b) and (c), Labor Code, are
  13-10  amended to read as follows:
  13-11        (b)  If the commission believes that a ground exists to
  13-12  revoke a certificate of authority to self-insure, the commission
  13-13  shall refer the matter to the State Office of Administrative
  13-14  Hearings.  That office shall hold a hearing to determine if the
  13-15  certificate should be revoked.  The hearing shall be conducted in
  13-16  the manner provided for a contested case hearing under Chapter
  13-17  2001, Government Code (the administrative procedure law
  13-18  <Administrative Procedure and Texas Register Act (Article 6252-13a,
  13-19  Vernon's Texas Civil Statutes>).
  13-20        (c)  The State Office of Administrative Hearings <commission>
  13-21  shall notify the certified self-insurer of the hearing and the
  13-22  grounds not later than the 30th day before the scheduled hearing
  13-23  date.
  13-24        SECTION 1.22.  Section 407.103(b), Labor Code, is amended to
  13-25  read as follows:
  13-26        (b)  To determine the tax base of a certified self-insurer
  13-27  for purposes of this chapter, the director shall multiply the
   14-1  amount of the certified self-insurer's liabilities for workers'
   14-2  compensation claims incurred in the previous year, including claims
   14-3  incurred but not reported, plus the amount of expense incurred by
   14-4  the certified self-insurer in the previous year for administration
   14-5  of self-insurance, including legal costs, by 1.02 <each certified
   14-6  self-insurer shall report its payroll by individual workers'
   14-7  compensation risk code classifications in its application for
   14-8  certification and in its annual reports to the commission.  The
   14-9  commission shall compute the estimated manual premium for the
  14-10  certified self-insurer using the workers' compensation insurance
  14-11  rates established by the State Board of Insurance.  The commission
  14-12  shall compute the certified self-insurer's tax base by multiplying
  14-13  the estimated manual premium by 0.75>.
  14-14        SECTION 1.23.  Section 407.122, Labor Code, is amended by
  14-15  amending Subsections (b) and (c) and by adding Subsection (d) to
  14-16  read as follows:
  14-17        (b)  The board of directors is composed of the following
  14-18  voting members:
  14-19              (1)  three <two> certified self-insurers;
  14-20              (2)  one commission member representing wage earners;
  14-21              (3)  one commission member representing employers; and
  14-22              (4)  <the executive director of the commission; and>
  14-23              <(5)>  the public counsel of the office of public
  14-24  insurance counsel.
  14-25        (c)  The executive director of the commission and the
  14-26  director of the division of self-insurance regulation serve
  14-27  <serves> as <a> nonvoting members <member> of the board of
   15-1  directors.
   15-2        (d)  A member of the board of directors or a member of the
   15-3  staff of the board of directors is not liable in a civil action for
   15-4  an act performed in good faith in the execution of that person's
   15-5  powers or duties.
   15-6        SECTION 1.24.  Section 407.126, Labor Code, is amended to
   15-7  read as follows:
   15-8        Sec. 407.126.  Trust Fund; Fee; SCHEDULE.  (a)  Each member
   15-9  of the association shall be assessed a fee, based on total amount
  15-10  of income benefits payments made in this state for the preceding
  15-11  reported calendar year, to create, over a period of 10 <five> years
  15-12  beginning January 1, 1993, a Texas certified self-insurer guaranty
  15-13  trust fund of at least $1 million for the emergency payment of the
  15-14  compensation liabilities of an impaired employer.  The fund may not
  15-15  exceed $2 million.
  15-16        (b)  The board of directors shall adopt a year-by-year
  15-17  schedule of assessments to meet the 10-year funding goal of the
  15-18  trust fund.
  15-19        (c)  The assessment for the first year after an employer is
  15-20  issued a certificate of authority to self-insure shall be based on
  15-21  the income benefit payments paid by the employer's insurance
  15-22  carrier on the employer's policy in the year before the certificate
  15-23  was issued.
  15-24        (d) <(c)>  The board of directors shall administer the trust
  15-25  fund in accordance with rules adopted by the commission.
  15-26        SECTION 1.25.  Section 408.023(b), Labor Code, is amended to
  15-27  read as follows:
   16-1        (b)  The commission shall establish criteria for deleting a
   16-2  doctor from the list of approved doctors.  The criteria may include
   16-3  anything the commission considers relevant, including:
   16-4              (1)  sanctions of the doctor by the commission for
   16-5  violations of Chapter 413 or Chapter 415;
   16-6              (2)  sanctions by the Medicare or Medicaid program for:
   16-7                    (A)  substandard medical care;
   16-8                    (B)  overcharging; or
   16-9                    (C)  overutilization of medical services;
  16-10              (3)  evidence from the commission's medical records
  16-11  that the doctor's charges, fees, diagnoses, or treatments are
  16-12  substantially different from those the commission finds to be fair
  16-13  and reasonable; and
  16-14              (4)  suspension of the doctor's license by the
  16-15  appropriate licensing authority.
  16-16        SECTION 1.26.  Section 408.083, Labor Code, is amended to
  16-17  read as follows:
  16-18        Sec. 408.083.  Termination of Right to Temporary Income,
  16-19  Impairment Income, and Supplemental Income Benefits.  (a)  Except
  16-20  as provided by Subsection (b), an <An> employee's eligibility for
  16-21  temporary income benefits, impairment income benefits, and
  16-22  supplemental income benefits terminates on the expiration of 401
  16-23  weeks after the date of injury.
  16-24        (b)  If an employee incurs an occupational disease, the
  16-25  employee's eligibility for temporary income benefits, impairment
  16-26  income benefits, and supplemental income benefits terminates on the
  16-27  expiration of 401 weeks after the date on which benefits began to
   17-1  accrue.
   17-2        SECTION 1.27.  Section 408.122, Labor Code, is amended to
   17-3  read as follows:
   17-4        Sec. 408.122.  Eligibility for Impairment Income Benefits;
   17-5  DESIGNATED DOCTOR.  (a)  A claimant may not recover impairment
   17-6  income benefits unless evidence of impairment based on an objective
   17-7  clinical or laboratory finding exists.  If the finding of
   17-8  impairment is made by a doctor chosen by the claimant and the
   17-9  finding is contested, a designated doctor or a doctor selected by
  17-10  the insurance carrier must be able to confirm the objective
  17-11  clinical or laboratory finding on which the finding of impairment
  17-12  is based.
  17-13        (b)  To be eligible to serve as a designated doctor, a doctor
  17-14  must meet specific qualifications, including training in the
  17-15  determination of impairment ratings.  The executive director shall
  17-16  develop qualification standards and administrative policies to
  17-17  implement this subsection, and the commission may adopt rules as
  17-18  necessary.  To the extent possible, a designated doctor must be in
  17-19  the same discipline and licensed by the same board of examiners as
  17-20  the employee's doctor of choice.
  17-21        (c)  If a dispute exists as to whether the employee has
  17-22  reached maximum medical improvement, the commission shall direct
  17-23  the employee to be examined by a designated doctor chosen by mutual
  17-24  agreement of the parties.  If the parties are unable to agree on a
  17-25  designated doctor, the commission shall direct the employee to be
  17-26  examined by a designated doctor chosen by the commission.  The
  17-27  designated doctor shall report to the commission.  The report of
   18-1  the designated doctor has presumptive weight, and the commission
   18-2  shall base its determination of whether the employee has reached
   18-3  maximum medical improvement on the report unless the great weight
   18-4  of the other medical evidence is to the contrary.
   18-5        SECTION 1.28.  Section 408.125, Labor Code, is amended by
   18-6  adding Subsections (f) and (g) to read as follows:
   18-7        (f)  To avoid undue influence on a person selected as a
   18-8  designated doctor under this section, only the injured employee or
   18-9  an appropriate member of the staff of the commission may
  18-10  communicate with the designated doctor about the case regarding the
  18-11  injured employee's medical condition or history before the
  18-12  examination of the injured employee by the designated doctor.
  18-13  After that examination is completed, communication with the
  18-14  designated doctor regarding the injured employee's medical
  18-15  condition or history may be made only through appropriate
  18-16  commission staff members.  The designated doctor may initiate
  18-17  communication with any doctor who has previously treated or
  18-18  examined the injured employee for the work-related injury.
  18-19        (g)  A violation of Subsection (f) is a Class C
  18-20  administrative violation.
  18-21        SECTION 1.29.   Section 409.005, Labor Code, is amended to
  18-22  read as follows:
  18-23        Sec. 409.005.  <Employer> Report of Injury; Administrative
  18-24  Violation.  (a)  An employer shall <file a written> report to
  18-25  <with> the <commission and the> employer's insurance carrier if:
  18-26              (1)  an injury results in the absence of an employee of
  18-27  that employer from work for more than one day; or
   19-1              (2)  an employee of the employer notifies that employer
   19-2  of an occupational disease under Section 409.001.
   19-3        (b)  The report under Subsection (a) must be made <mailed or
   19-4  delivered to the commission and the insurance carrier> not later
   19-5  than the eighth day after:
   19-6              (1)  the employee's absence from work for more than one
   19-7  day due to an injury; or
   19-8              (2)  the day on which the employer receives notice
   19-9  under Section 409.001 that the employee has contracted an
  19-10  occupational disease.
  19-11        (c)  The <A report required under this section may not be
  19-12  considered to be an admission by or evidence against an> employer
  19-13  shall deliver a written copy of the report under Subsection (a) to
  19-14  the injured employee at the time that the report is made to the <or
  19-15  an> insurance carrier <in a proceeding before the commission or a
  19-16  court in which the facts set out in the report are contradicted by
  19-17  the employer or insurance carrier>.
  19-18        (d)  The insurance carrier shall file the report of the
  19-19  injury on behalf of the policyholder.  Except as provided by
  19-20  Subsection (e), the insurance carrier must electronically file the
  19-21  report with the commission not later than the seventh day after the
  19-22  date on which the carrier receives the report from the employer.
  19-23        (e)  The executive director may waive the electronic filing
  19-24  requirement under Subsection (d) and allow an insurance carrier to
  19-25  mail or deliver the report to the commission not later than the
  19-26  seventh day after the date on which the carrier receives the report
  19-27  from the employer.
   20-1        (f)  A report required under this section may not be
   20-2  considered to be an admission by or evidence against an employer or
   20-3  an insurance carrier in a proceeding before the commission or a
   20-4  court in which the facts set out in the report are contradicted by
   20-5  the employer or insurance carrier.
   20-6        (g)  In addition to any information required under Subsection
   20-7  (h), the report provided to the injured employee under Subsection
   20-8  (c) must contain a summary written in plain language of the
   20-9  employee's statutory rights and responsibilities under this
  20-10  subtitle.
  20-11        (h) <(d)>  The commission may adopt rules relating to:
  20-12              (1)  the information that must be contained in a report
  20-13  required under this section, including the summary of rights and
  20-14  responsibilities required under Subsection (g); and
  20-15              (2)  the development and implementation of an
  20-16  electronic filing system for injury reports under this section.
  20-17        (i) <(e)>  An employer and insurance carrier shall file
  20-18  subsequent reports as required by commission rule.
  20-19        (j) <(f)>  A person commits a violation if the person fails
  20-20  to comply with this section unless good cause exists.  A violation
  20-21  under this subsection is a Class D administrative violation.
  20-22        SECTION 1.30.  Subchapter A, Chapter 409, Labor Code, is
  20-23  amended by adding Section 409.013 to read as follows:
  20-24        Sec. 409.013.  PLAIN LANGUAGE INFORMATION; NOTIFICATION OF
  20-25  INJURED WORKER.  (a)  The commission shall develop information for
  20-26  public dissemination about the benefit process and the compensation
  20-27  procedures established under this chapter.  The information must be
   21-1  written in plain language and must be available in English and
   21-2  Spanish.
   21-3        (b)  On receipt of a report under Section 409.005, the
   21-4  commission shall contact the affected employee by mail or by
   21-5  telephone and shall provide the information required under
   21-6  Subsection (a) to that employee, together with any other
   21-7  information that may be prepared by the commission for public
   21-8  dissemination that relates to the employee's situation, such as
   21-9  information relating to back injuries or occupational diseases.
  21-10        SECTION 1.31.  Subchapter C, Chapter 409, Labor Code, is
  21-11  amended to read as follows:
  21-12                   SUBCHAPTER C.  OMBUDSMAN PROGRAM
  21-13        Sec. 409.041.  Ombudsman Program<; ADMINISTRATIVE VIOLATION>.
  21-14  (a)  The commission shall maintain an ombudsman program as provided
  21-15  by this subchapter to assist injured workers and persons claiming
  21-16  death benefits in obtaining benefits under this subtitle.
  21-17        (b)  An ombudsman shall:
  21-18              (1)  meet with or otherwise provide information to
  21-19  injured workers;
  21-20              (2)  investigate complaints;
  21-21              (3)  communicate with employers, insurance carriers,
  21-22  and health care providers on behalf of injured workers; <and>
  21-23              (4)  assist unrepresented claimants, employers, and
  21-24  other parties to enable those persons to protect their rights in
  21-25  the workers' compensation system; and
  21-26              (5)  meet with an unrepresented claimant privately for
  21-27  a minimum of 15 minutes prior to any informal or formal hearing.
   22-1        Sec. 409.042.  DESIGNATION AS OMBUDSMAN; ELIGIBILITY AND
   22-2  TRAINING REQUIREMENTS; CONTINUING EDUCATION REQUIREMENTS.
   22-3  (a) <(c)>  At least one specially qualified employee in each
   22-4  commission office shall be designated an ombudsman who shall
   22-5  perform the duties under this section as the person's primary
   22-6  responsibility.
   22-7        (b)  To be eligible for designation as an ombudsman, a person
   22-8  must:
   22-9              (1)  demonstrate satisfactory knowledge of the
  22-10  requirements of:
  22-11                    (A)  this subtitle and the provisions of Subtitle
  22-12  C that relate to claims management;
  22-13                    (B)  other laws relating to workers'
  22-14  compensation; and
  22-15                    (C)  rules adopted under this subtitle and the
  22-16  laws described under Subdivision (1)(B);
  22-17              (2)  have demonstrated experience in handling and
  22-18  resolving problems for the general public;
  22-19              (3)  possess strong interpersonal skills; and
  22-20              (4)  have at least three years of demonstrated
  22-21  experience in the field of workers' compensation.
  22-22        (c)  The commission by rule shall adopt training guidelines
  22-23  and continuing education requirements for ombudsmen.  Training
  22-24  provided under this subsection must:
  22-25              (1)  include education regarding this subtitle, rules
  22-26  adopted under this subtitle, and appeals panel decisions, with
  22-27  emphasis on benefits and the dispute resolution process; and
   23-1              (2)  require an ombudsman undergoing training to be
   23-2  observed and monitored by an experienced ombudsman during daily
   23-3  activities conducted under this subchapter.
   23-4        Sec. 409.043.  EMPLOYER NOTIFICATION; ADMINISTRATIVE
   23-5  VIOLATION.  (a) <(d)>  Each employer shall notify its employees of
   23-6  the ombudsman program in a manner prescribed by the commission.
   23-7        (b)  An employer commits a violation if the employer fails to
   23-8  comply with this section <subsection>.  A violation under this
   23-9  section <subsection> is a Class C administrative violation.
  23-10        Sec. 409.044 <409.042>.  PUBLIC INFORMATION.  The commission
  23-11  shall widely disseminate information about the ombudsman program.
  23-12        SECTION 1.32.  Section 411.032, Labor Code, is amended to
  23-13  read as follows:
  23-14        Sec. 411.032.  Employer Injury and Occupational Disease
  23-15  Report; ADMINISTRATIVE VIOLATION.  (a)  An employer shall file with
  23-16  the commission a report of each:
  23-17              (1)  on-the-job injury that results in the employee's
  23-18  absence from work for more than one day; and
  23-19              (2)  occupational disease of which the employer has
  23-20  knowledge.
  23-21        (b)  The commission shall adopt rules and prescribe the form
  23-22  and manner of reports filed under this section.
  23-23        (c)  An employer commits an administrative violation if the
  23-24  employer fails to report to the commission as required under
  23-25  Subsection (a) unless good cause exists, as determined by the
  23-26  commission, for the failure.  A violation under this subsection is
  23-27  a Class D administrative violation.
   24-1        SECTION 1.33.  Section 411.034, Labor Code, is amended to
   24-2  read as follows:
   24-3        Sec. 411.034.  Confidentiality Requirement; OFFENSE; PENALTY.
   24-4  (a)  The identity of an employee in a report filed under Section
   24-5  411.032 is confidential and may not be disclosed as part of the job
   24-6  safety information system.
   24-7        (b)  A person commits an offense if the person knowingly,
   24-8  intentionally, or recklessly publishes, discloses, or distributes
   24-9  information that is confidential under this section to a person not
  24-10  authorized to receive the information.
  24-11        (c)  A person commits an offense if the person knowingly,
  24-12  intentionally, or recklessly receives information that is
  24-13  confidential under this section and that the person is not
  24-14  authorized to receive.
  24-15        (d)  An offense under this section is a Class A misdemeanor.
  24-16        (e)  An offense under this section may be prosecuted in a
  24-17  court in the county where the information was unlawfully received,
  24-18  published, disclosed, or distributed.
  24-19        (f)  A district court in Travis County has jurisdiction to
  24-20  enjoin the use, publication, disclosure, or distribution of
  24-21  confidential information under this section.
  24-22        SECTION 1.34.  Section 411.041(b), Labor Code, is amended to
  24-23  read as follows:
  24-24        (b)  Except as provided by Section 411.0415, an <An> employer
  24-25  whose injury frequencies substantially exceed those that may
  24-26  reasonably be expected in that employer's business or industry is
  24-27  an extra-hazardous employer.
   25-1        SECTION 1.35.  Subchapter D, Chapter 411, Labor Code, is
   25-2  amended by adding Section 411.0415 to read as follows:
   25-3        Sec. 411.0415.  EXEMPTION FOR CERTAIN EMPLOYERS; HEARING.
   25-4  (a)  The executive director may exclude from identification as an
   25-5  extra-hazardous employer an employer who presents evidence
   25-6  satisfactory to the commission that the injury frequencies of the
   25-7  employer substantially exceed those that may reasonably be expected
   25-8  in that employer's business or industry only because of a fatality
   25-9  that:
  25-10              (1)  occurred because of factors beyond the employer's
  25-11  control; or
  25-12              (2)  was outside the course and scope of the deceased
  25-13  individual's employment.
  25-14        (b)  The commission by rule shall analyze and list fatalities
  25-15  that may not be related to the work environment, including:
  25-16              (1)  heart attacks;
  25-17              (2)  common diseases of life;
  25-18              (3)  homicides;
  25-19              (4)  suicides;
  25-20              (5)  vehicle accidents involving a third party;
  25-21              (6)  common carrier accidents; and
  25-22              (7)  natural events.
  25-23        (c)  If the commission determines that the case history of
  25-24  the employee's fatality indicates that the employer or the work
  25-25  environment was a proximate cause of the fatality, the commission
  25-26  may request a hearing under Section 411.049.  If the hearing
  25-27  establishes that a proximate cause of the fatality was a factor or
   26-1  factors within the employer's control and was within the course and
   26-2  scope of the employment, the commission may require the employer to
   26-3  participate in the extra-hazardous employers program if that
   26-4  fatality causes the employer to be designated as an extra-hazardous
   26-5  employer.
   26-6        SECTION 1.36.  Section 411.045(a), Labor Code, is amended to
   26-7  read as follows:
   26-8        (a)  Not earlier than six months or later than nine <Six>
   26-9  months after the formulation of an accident prevention plan under
  26-10  Section 411.043, the division shall conduct a follow-up inspection
  26-11  of the employer's premises.  The commission may require the
  26-12  participation of the safety consultant who performed the initial
  26-13  consultation and formulated the safety plan.
  26-14        SECTION 1.37.  Section 411.049(b), Labor Code, is amended to
  26-15  read as follows:
  26-16        (b)  The hearing shall be conducted by the State Office of
  26-17  Administrative Hearings in the manner provided for a contested case
  26-18  under Chapter 2001, Government Code (the administrative procedure
  26-19  law <Administrative Procedure and Texas Register Act (Article
  26-20  6252-13a, Vernon's Texas Civil Statutes>) and is subject to
  26-21  judicial review as provided by that chapter <Act>.
  26-22        SECTION 1.38.  Section 411.062, Labor Code, is amended to
  26-23  read as follows:
  26-24        Sec. 411.062.  Field Safety Representative; Qualifications.
  26-25  (a)  The commission by rule shall establish qualifications for
  26-26  field safety representatives.  The rules must include education and
  26-27  experience requirements for those representatives.
   27-1        (b)  Each <A> field safety representative must meet the
   27-2  qualifications established by the commission <be:>
   27-3              <(1)  a college graduate with a bachelor's degree in
   27-4  science or engineering;>
   27-5              <(2)  a registered professional engineer;>
   27-6              <(3)  a certified safety professional;>
   27-7              <(4)  a certified industrial hygienist;>
   27-8              <(5)  an individual with 10 years' experience in
   27-9  occupational safety and health; or>
  27-10              <(6)  an individual who has completed a certified
  27-11  training program in accident prevention services approved by the
  27-12  division>.
  27-13        SECTION 1.39.  Chapter 412, Labor Code, is amended by adding
  27-14  Section 412.0025 to read as follows:
  27-15        Sec. 412.0025.  DUTIES OF STATE AGENCIES.  Each state agency
  27-16  subject to this chapter shall actively manage the risks of that
  27-17  agency by developing, implementing, and maintaining health and
  27-18  safety programs and programs designed to assist employees who
  27-19  sustain compensable injuries to return to work.
  27-20        SECTION 1.40.  Section 412.003(a), Labor Code, is amended to
  27-21  read as follows:
  27-22        (a)  The division shall:
  27-23              (1)  administer guidelines adopted by the commission
  27-24  for a comprehensive risk management program applicable to all state
  27-25  agencies to reduce property and liability losses, including
  27-26  workers' compensation losses; and
  27-27              (2)  review, verify, monitor, and approve risk
   28-1  management programs adopted by state agencies.
   28-2        SECTION 1.41.  Section 412.007(b), Labor Code, is amended to
   28-3  read as follows:
   28-4        (b)  The report must include:
   28-5              (1)  the frequency, severity, and aggregate amount of
   28-6  open and closed claims in the preceding biennium by category of
   28-7  risk, including final judgments;
   28-8              (2)  the identification of each state agency that has
   28-9  not complied with the risk management guidelines and reporting
  28-10  requirements of this chapter; and
  28-11              (3)  recommendations for the coordination and
  28-12  administration of a comprehensive risk management program to serve
  28-13  all state agencies, including recommendations for any necessary
  28-14  statutory changes.
  28-15        SECTION 1.42.  Section 413.002, Labor Code, is amended by
  28-16  adding Subsection (c) to read as follows:
  28-17        (c)  In monitoring health care providers who serve as
  28-18  designated doctors under Chapter 408, the division shall evaluate
  28-19  the compliance of those providers with this subtitle and with rules
  28-20  adopted by the commission relating to medical policies, fee
  28-21  guidelines, and impairment ratings.
  28-22        SECTION 1.43.  Section 413.031(d), Labor Code, is amended to
  28-23  read as follows:
  28-24        (d)  A party to a medical dispute that remains unresolved
  28-25  after a review of the medical service under this section is
  28-26  entitled to a hearing.  The hearing shall be conducted by the State
  28-27  Office of Administrative Hearings within 90 days of receipt of a
   29-1  request for a hearing in the manner provided for a contested case
   29-2  under Chapter 2001, Government Code (the administrative procedure
   29-3  law <Administrative Procedure and Texas Register Act (Article
   29-4  6252-13a, Vernon's Texas Civil Statutes>).
   29-5        SECTION 1.44.  Subchapter D, Chapter 413, Labor Code, is
   29-6  amended by adding Section 413.044 to read as follows:
   29-7        Sec. 413.044.  SANCTIONS ON DESIGNATED DOCTOR.  In addition
   29-8  to or in lieu of an administrative penalty under Section 415.021 or
   29-9  a sanction imposed under Section 415.023, the commission may impose
  29-10  sanctions against a person who serves as a designated doctor under
  29-11  Chapter 408 who, after an evaluation conducted under Section
  29-12  413.002(c), is determined by the division to be out of compliance
  29-13  with this subtitle or with rules adopted by the commission relating
  29-14  to medical policies, fee guidelines, and impairment ratings.
  29-15        SECTION 1.45.  Subchapter A, Chapter 415, Labor Code, is
  29-16  amended by amending Sections 415.002 and 415.003 and by adding
  29-17  Section 415.0035 to read as follows:
  29-18        Sec. 415.002.  Administrative Violation by an Insurance
  29-19  Carrier.  (a)  An insurance carrier or its representative commits
  29-20  an administrative violation if that person wilfully or
  29-21  intentionally:
  29-22              (1)  misrepresents a provision of this subtitle to an
  29-23  employee, an employer, a health care provider, or a legal
  29-24  beneficiary;
  29-25              (2)  <fails to submit to the commission a settlement or
  29-26  agreement of the parties;>
  29-27              <(3)  fails to timely notify the commission of the
   30-1  termination or reduction of benefits and the reason for that
   30-2  action;>
   30-3              <(4)>  terminates or reduces benefits without
   30-4  substantiating evidence that the action is reasonable and
   30-5  authorized by law;
   30-6              (3) <(5)>  instructs an employer not to file a document
   30-7  required to be filed with the commission;
   30-8              (4) <(6)>  instructs or encourages an employer to
   30-9  violate a claimant's right to medical benefits under this subtitle;
  30-10              (5) <(7)>  fails to tender promptly full death benefits
  30-11  if a legitimate dispute does not exist as to the liability of the
  30-12  insurance carrier;
  30-13              (6) <(8)>  allows an employer, other than a
  30-14  self-insured employer, to dictate the methods by which and the
  30-15  terms on which a claim is handled and settled;
  30-16              (7) <(9)>  fails to confirm medical benefits coverage
  30-17  to a person or facility providing medical treatment to a claimant
  30-18  if a legitimate dispute does not exist as to the liability of the
  30-19  insurance carrier;
  30-20              (8) <(10)>  fails, without good cause, to attend a
  30-21  dispute resolution proceeding within the commission;
  30-22              (9) <(11)>  attends a dispute resolution proceeding
  30-23  within the commission without complete authority or fails to
  30-24  exercise authority to effectuate agreement or settlement;
  30-25              (10) <(12)>  adjusts a workers' compensation claim in a
  30-26  manner contrary to license requirements for an insurance adjuster,
  30-27  including the requirements of Chapter 407, Acts of the 63rd
   31-1  Legislature, Regular Session, 1973 (Article 21.07-4, Vernon's Texas
   31-2  Insurance Code), or the rules of the State Board of Insurance;
   31-3              (11) <(13)>  fails to process claims promptly in a
   31-4  reasonable and prudent manner;
   31-5              (12) <(14)>  fails to initiate or reinstate benefits
   31-6  when due if a legitimate dispute does not exist as to the liability
   31-7  of the insurance carrier;
   31-8              (13) <(15)>  misrepresents the reason for not paying
   31-9  benefits or terminating or reducing the payment of benefits;
  31-10              (14) <(16)>  dates documents to misrepresent the actual
  31-11  date of the initiation of benefits;
  31-12              (15) <(17)>  makes a notation on a draft or other
  31-13  instrument indicating that the draft or instrument represents a
  31-14  final settlement of a claim if the claim is still open and pending
  31-15  before the commission;
  31-16              (16) <(18)>  fails or refuses to pay benefits from week
  31-17  to week as and when due directly to the person entitled to the
  31-18  benefits;
  31-19              (17) <(19)>  fails to pay an order awarding benefits;
  31-20              (18) <(20)>  controverts a claim if the evidence
  31-21  clearly indicates liability;
  31-22              (19) <(21)  unreasonably denies preauthorization
  31-23  required under Section 413.014 or> unreasonably disputes the
  31-24  reasonableness and necessity of health care;
  31-25              (20) <(22)>  violates a commission rule; or
  31-26              (21) <(23)>  fails to comply with a provision of this
  31-27  subtitle.
   32-1        (b)  An insurance carrier or its representative does not
   32-2  commit an administrative violation under Subsection (a)(6)<(8)> by
   32-3  allowing an employer to:
   32-4              (1)  freely discuss a claim;
   32-5              (2)  assist in the investigation and evaluation of a
   32-6  claim; or
   32-7              (3)  attend a proceeding of the commission and
   32-8  participate at the proceeding in accordance with this subtitle.
   32-9        Sec. 415.003.  Administrative Violation by Health Care
  32-10  Provider.  A health care provider commits an administrative
  32-11  violation if the person wilfully or intentionally:
  32-12              (1)  submits a charge for health care that was not
  32-13  furnished;
  32-14              (2)  administers improper, unreasonable, or medically
  32-15  unnecessary treatment or services;
  32-16              (3)  <fails or refuses to timely file required reports
  32-17  or records;>
  32-18              <(4)>  makes an unnecessary referral;
  32-19              (4) <(5)  fails to disclose an interest as required by
  32-20  Section 413.041;>
  32-21              <(6)>  violates the commission's fee and treatment
  32-22  guidelines;
  32-23              (5) <(7)>  violates a commission rule; or
  32-24              (6) <(8)>  fails to comply with a provision of this
  32-25  subtitle.
  32-26        Sec. 415.0035.  ADDITIONAL VIOLATIONS BY INSURANCE CARRIER OR
  32-27  HEALTH CARE PROVIDER.  (a)  An insurance carrier or its
   33-1  representative commits an administrative violation if that person:
   33-2              (1)  fails to submit to the commission a settlement or
   33-3  agreement of the parties;
   33-4              (2)  fails to timely notify the commission of the
   33-5  termination or reduction of benefits and the reason for that
   33-6  action; or
   33-7              (3)  denies preauthorization in a manner that is not in
   33-8  accordance with rules adopted by the commission under Section
   33-9  413.014.
  33-10        (b)  A health care provider commits an administrative
  33-11  violation if that person:
  33-12              (1)  fails or refuses to timely file required reports
  33-13  or records; or
  33-14              (2)  fails to file with the commission the annual
  33-15  disclosure statement required by Section 413.041.
  33-16        (c)  A violation under Subsection (a) is a Class C
  33-17  administrative violation.
  33-18        (d)  A violation under Subsection (b) is a Class D
  33-19  administrative violation.
  33-20        SECTION 1.46.  Section 415.034(a), Labor Code, is amended to
  33-21  read as follows:
  33-22        (a)  On the request of the charged party or <at the
  33-23  discretion of> the executive director <of the division of
  33-24  hearings>, the State Office of Administrative Hearings <division of
  33-25  hearings> shall set a hearing.  The hearing shall be conducted in
  33-26  the manner provided for a contested case under Chapter 2001,
  33-27  Government Code (the administrative procedure law <Administrative
   34-1  Procedure and Texas Register Act (Article 6252-13a, Vernon's Texas
   34-2  Civil Statutes>).
   34-3        SECTION 1.47.  Subtitle A, Title 5, Labor Code, is amended by
   34-4  adding Chapter 418 to read as follows:
   34-5                   CHAPTER 418.  CRIMINAL PENALTIES
   34-6        Sec. 418.001.  PENALTY FOR FRAUDULENTLY OBTAINING OR DENYING
   34-7  BENEFITS.  (a)  A person commits an offense if the person, with the
   34-8  intent to obtain or deny payment of benefits, including medical
   34-9  benefits, under this subtitle or Subtitle C, for himself or
  34-10  another, knowingly or intentionally:
  34-11              (1)  makes a false or misleading statement;
  34-12              (2)  misrepresents or conceals a material fact; or
  34-13              (3)  fabricates, alters, conceals, or destroys a
  34-14  document other than a governmental record.
  34-15        (b)  An offense under Subsection (a) is:
  34-16              (1)  a Class A misdemeanor if the value of the benefits
  34-17  is less than $1,500; and
  34-18              (2)  a state jail felony if the value of the benefits
  34-19  is $1,500 or more.
  34-20        Sec. 418.002.  PENALTY FOR FRAUDULENTLY OBTAINING WORKERS'
  34-21  COMPENSATION INSURANCE COVERAGE.  (a)  A person commits an offense
  34-22  if the person, with the intent to obtain workers' compensation
  34-23  insurance coverage under the workers' compensation insurance laws
  34-24  of this state or to avoid payment of premiums due for that
  34-25  coverage, for himself or another, knowingly or intentionally:
  34-26              (1)  makes a false statement;
  34-27              (2)  misrepresents or conceals a material fact; or
   35-1              (3)  makes a false entry in, fabricates, alters,
   35-2  conceals, or destroys a document other than a governmental record.
   35-3        (b)  An offense under Subsection (a) is:
   35-4              (1)  a Class A misdemeanor if the amount of premium
   35-5  avoided is less than $1,500; and
   35-6              (2)  a state jail felony if the amount of the premium
   35-7  avoided is $1,500 or more.
   35-8        (c)  The court may order a person to pay restitution to an
   35-9  insurance company, the Texas workers' compensation insurance
  35-10  facility, or the Texas Workers' Compensation Insurance Fund if the
  35-11  person commits an offense under this section.
  35-12        SECTION 1.48.  (a)  The change in law made by Sections
  35-13  402.001, 402.005, and 402.012, Labor Code, as amended or added by
  35-14  this Act, in the qualifications and the grounds for removal of
  35-15  persons appointed to the Texas Workers' Compensation Commission
  35-16  applies only to a member appointed on or after September 1, 1995,
  35-17  and does not affect the entitlement of a member appointed before
  35-18  September 1, 1995, to continue to hold office for the term for
  35-19  which the member was appointed.
  35-20        (b)  The training program required under Section 402.0015,
  35-21  Labor Code, as added by this Act, shall be established not later
  35-22  than January 1, 1996.  Each person appointed to the commission on
  35-23  or after that date must comply with the requirements imposed under
  35-24  that section.
  35-25        SECTION 1.49.  The Texas Workers' Compensation Commission
  35-26  shall adopt rules as necessary to implement the changes in law made
  35-27  by this Act to Title 5, Labor Code, not later than March 1, 1996.
   36-1        SECTION 1.50.  Section 406.097, Labor Code, as added by this
   36-2  Act, applies only to an insurance policy or certificate of
   36-3  authority to self-insure that is delivered, issued for delivery, or
   36-4  renewed on or after January 1, 1996.  A policy or certificate that
   36-5  is delivered, issued for delivery, or renewed before January 1,
   36-6  1996, is governed by the law as it existed immediately before
   36-7  September 1, 1995, and that law is continued in effect for that
   36-8  purpose.
   36-9        SECTION 1.51.  The change in law made by this Act to Section
  36-10  408.083, Labor Code, applies only to an occupational disease for
  36-11  which the date of injury occurs on or after September 1, 1995.  A
  36-12  claim based on an occupational disease for which the date of injury
  36-13  occurs before September 1, 1995, is governed by the law in effect
  36-14  on the date of injury for that occupational disease, and the former
  36-15  law is continued in effect for that purpose.
  36-16        SECTION 1.52.  The change in law made by this Act to Section
  36-17  409.005, Labor Code, applies only to an injury report regarding a
  36-18  compensable injury that occurs on or after September 1, 1995.  An
  36-19  injury report for a compensable injury that occurs before that date
  36-20  is governed by the law in effect on the date that the injury
  36-21  occurred, and the former law is continued in effect for that
  36-22  purpose.
  36-23        SECTION 1.53.  The change in law made by this Act to
  36-24  Subchapter C, Chapter 409, Labor Code, in the qualifications of
  36-25  persons who serve as ombudsmen under the Texas Workers'
  36-26  Compensation Commission applies only to a person who is designated
  36-27  as an ombudsman on or after September 1, 1995.  The change does not
   37-1  affect the entitlement of a person serving as an ombudsman
   37-2  immediately before that date to continue to serve as an ombudsman
   37-3  if that person continues to meet the qualifications for that
   37-4  service that were in effect before September 1, 1995, and complies
   37-5  with applicable continuing education requirements adopted by the
   37-6  commission.
   37-7        SECTION 1.54.  The change in law made by Section 402.092,
   37-8  Labor Code, as added by this Act, applies to information maintained
   37-9  in investigation files of the Texas Workers' Compensation
  37-10  Commission without regard to the date the information is collected,
  37-11  compiled, developed, or otherwise becomes part of the investigation
  37-12  file.
  37-13        SECTION 1.55.  The change in law made by this Act to Section
  37-14  411.062, Labor Code, in the qualifications of a person who serves
  37-15  as a field safety representative, applies only to a person employed
  37-16  as a field safety representative on or after September 1, 1995.
  37-17  The change does not affect the entitlement of a person serving as a
  37-18  field safety representative immediately before that date to
  37-19  continue to serve as a field safety representative if the person
  37-20  continues to meet the qualifications for that service that were in
  37-21  effect before September 1, 1995, and complies with applicable
  37-22  continuing education requirements adopted by the Texas Workers'
  37-23  Compensation Commission.
  37-24        SECTION 1.56.  A state agency subject to Section 412.0025,
  37-25  Labor Code, as added by this Act, shall develop programs as
  37-26  required by that section not later than January 1, 1996.
  37-27        SECTION 1.57.  A change in law under this Act that transfers
   38-1  jurisdiction of a hearing to the State Office of Administrative
   38-2  Hearings takes effect January 1, 1996.  A hearing held before or
   38-3  pending on December 31, 1995, is governed by the law in effect
   38-4  immediately before September 1, 1995, and that law is continued in
   38-5  effect for that purpose.
   38-6        SECTION 1.58.  (a)  The change in law made to Subtitle A,
   38-7  Title 5, Labor Code, by this Act applies only to a penalty or
   38-8  sanction for an offense committed on or after the effective date of
   38-9  this Act.
  38-10        (b)  For purposes of this section, an offense is committed
  38-11  before the effective date of this Act if any element of the offense
  38-12  occurs before that date.
  38-13        (c)  An offense committed before the effective date of this
  38-14  Act is governed by the law in effect when the offense was
  38-15  committed, and the former law is continued in effect for that
  38-16  purpose.
  38-17         ARTICLE 2.  WORKERS' COMPENSATION INSURANCE COVERAGE
  38-18                  FOR CERTAIN GOVERNMENTAL EMPLOYEES
  38-19        SECTION 2.01.  Sections 501.002(b) and (c), Labor Code, are
  38-20  amended to read as follows:
  38-21        (b)  For the purposes of this chapter and Chapter 451, the
  38-22  individual state agency shall be considered the employer.
  38-23        (c)  For the purpose of applying the provisions listed by
  38-24  Subsection (a) to this chapter, "insurer" or "employer" means
  38-25  "state," "division," <or> "director," or "state agency," as
  38-26  applicable.
  38-27        SECTION 2.02.  Section 501.022, Labor Code, is amended to
   39-1  read as follows:
   39-2        Sec. 501.022.  TEXAS TECH UNIVERSITY EMPLOYEES.  (a)  An
   39-3  eligible employee of Texas Tech University, Texas Tech University
   39-4  Health Sciences Center <Research Farm, Texas Tech University School
   39-5  of Medicine at Lubbock>, or another agency under the direction and
   39-6  control of the board of regents of Texas Tech University and Texas
   39-7  Tech University Health Sciences Center is entitled to participate
   39-8  in the workers' compensation program for state employees provided
   39-9  under this chapter.
  39-10        (b)  For purposes of this chapter, Texas Tech University is a
  39-11  state agency and shall act in the capacity of employer.
  39-12        (c)  For purposes of this chapter, Texas Tech University
  39-13  Health Sciences Center is a state agency and shall act in the
  39-14  capacity of employer.
  39-15        SECTION 2.03.  Section 501.042, Labor Code, is amended to
  39-16  read as follows:
  39-17        Sec. 501.042.  DIRECTOR AS <EMPLOYER AND> INSURER.  (a)  In
  39-18  administering and enforcing this chapter, the director shall act in
  39-19  the capacity of <employer and> insurer.
  39-20        (b)  The director shall act as an adversary before the
  39-21  commission and courts and present the legal defenses and positions
  39-22  of the state as an <employer and> insurer.
  39-23        (c)  For the purposes of this section, the director is
  39-24  entitled to the legal counsel of the attorney general.
  39-25        (d)  The director is subject to the rules, orders, and
  39-26  decisions of the commission in the same manner as an <a private
  39-27  employer,> insurer<,> or association.
   40-1        SECTION 2.04.  Section 501.043(a), Labor Code, is amended to
   40-2  read as follows:
   40-3        (a)  The director shall<:>
   40-4              <(1)>  adopt procedural rules and prescribe forms
   40-5  necessary for the effective administration of this chapter<; and>
   40-6              <(2)  adopt and enforce reasonable rules for the
   40-7  prevention of accidents and injuries>.
   40-8        SECTION 2.05.  The change in law made by this Act to Chapter
   40-9  501, Labor Code, applies only to a claim for workers' compensation
  40-10  benefits based on a compensable injury that occurs on or after
  40-11  September 1, 1995.  A claim based on a compensable injury that
  40-12  occurs before that date is governed by the law in effect on the
  40-13  date that the injury occurred, and the former law is continued in
  40-14  effect for that purpose.
  40-15                   ARTICLE 3.  CONFORMING AMENDMENTS
  40-16        SECTION 3.01.  Section 2003.001(3), Government Code, is
  40-17  amended to read as follows:
  40-18              (3)  "State agency" means:
  40-19                    (A)  a state board, commission, department, or
  40-20  other agency that is subject to Chapter 2001; and
  40-21                    (B)  to the extent provided by Title 5, Labor
  40-22  Code, the Texas Workers' Compensation Commission.
  40-23        SECTION 3.02.  Section 2003.021, Government Code, is amended
  40-24  by adding Subsection (c) to read as follows:
  40-25        (c)  The office shall conduct hearings under Title 5, Labor
  40-26  Code, as provided by that title.  In conducting hearings under
  40-27  Title 5, Labor Code, the office shall consider the applicable
   41-1  substantive rules and policies of the Texas Workers' Compensation
   41-2  Commission.  The office and the Texas Workers' Compensation
   41-3  Commission shall enter into an interagency contract under Chapter
   41-4  771 to pay the costs incurred by the office in implementing this
   41-5  subsection.
   41-6                 ARTICLE 4.  MISCELLANEOUS PROVISIONS
   41-7        SECTION 4.01.  The changes in law made by this Act to Chapter
   41-8  2003, Government Code, and Sections 407.046, 411.049(b),
   41-9  413.031(d), and 415.034, Labor Code, apply only to a hearing that
  41-10  begins on or after January 1, 1996.  A hearing held before or
  41-11  pending on January 1, 1996, is governed by the law in effect
  41-12  immediately before September 1, 1995, and that law is continued in
  41-13  effect for that purpose.
  41-14        SECTION 4.02.  This Act takes effect September 1, 1995.
  41-15        SECTION 4.03.  The importance of this legislation and the
  41-16  crowded condition of the calendars in both houses create an
  41-17  emergency and an imperative public necessity that the
  41-18  constitutional rule requiring bills to be read on three several
  41-19  days in each house be suspended, and this rule is hereby suspended.