Amend CSHB 3522 by striking all below the enacting clause and
substituting the following:
SECTION 1. Section 401.011(30), Labor Code, is amended to
read as follows:
(30) "Maximum medical improvement" means the earlier
of:
(A) the earliest date after which, based on
reasonable medical probability, further material recovery from or
lasting improvement to an injury can no longer reasonably be
anticipated; <or>
(B) the expiration of 104 weeks from the date on
which income benefits begin to accrue; or
(C) the date determined as provided by Section
408.104.
SECTION 2. Section 402.011, Labor Code, is amended by
amending Subsection (b) and adding Subsections (c) and (d) to read
as follows:
(b) A member is entitled to reimbursement for actual lost
wages, if any, for:
(1) <due to> attendance at commission meetings, not to
exceed one day in each calendar quarter;
(2) preparation for a commission meeting, not to
exceed two days in each calendar quarter;
(3) attendance at a subcommittee meeting, not to
exceed one day each month;
(4) attendance by the chair or vice chair of the
commission at a legislative committee meeting if attendance is
requested by the committee chair; and
(5) attendance at a meeting by a member appointed to
the Research and Oversight Council on Workers' Compensation or the
Texas Certified Self-Insured Guarantee Association.
(c) Reimbursement under Subsection (b) <this subsection> may
not exceed $100 a day and $12,000 a year.
(d) A member of the commission is entitled to reimbursement
for actual and necessary expenses for attendance at not more than
five seminars in a calendar year if:
(1) the member is invited as a representative of the
commission to participate in a program offered at the seminar; and
(2) the member's participation is approved by the
chair of the commission.
SECTION 3. Sections 403.002(a) and (b), Labor Code, are
amended to read as follows:
(a) Each insurance carrier, other than a governmental
entity, shall pay an annual maintenance tax to pay the costs of
administering this subtitle and to support the prosecution of
workers' compensation insurance fraud in this state.
(b) The assessment may not exceed an amount equal to two
percent of the correctly reported gross workers' compensation
insurance premiums. Out of this amount, and in addition to the
amounts assessed to pay the costs of administration, an amount not
to exceed one-tenth of one percent of correctly reported gross
premiums shall be assessed annually to support the prosecution of
workers' compensation insurance fraud.
SECTION 4. Section 403.003(a), Labor Code, is amended to
read as follows:
(a) The commission shall set and certify to the comptroller
the rate of maintenance tax assessment not later than October 31 of
each year, taking into account:
(1) any expenditure projected as necessary for the
commission to:
(A) administer this subtitle during the fiscal
year for which the rate of assessment is set; and
(B) reimburse the general revenue fund as
provided by Article 4.19, Insurance Code;
(2) projected employee benefits paid from general
revenues;
(3) a surplus or deficit produced by the tax in the
preceding year; <and>
(4) revenue recovered from other sources, including
reappropriated receipts, grants, payments, fees, gifts, and
penalties recovered under this subtitle; and
(5) expenditures projected as necessary to support the
prosecution of workers' compensation insurance fraud.
SECTION 5. Subchapter F, Chapter 408, Labor Code, is amended
by adding Section 408.104 to read as follows:
Sec. 408.104. MAXIMUM MEDICAL IMPROVEMENT AFTER SPINAL
SURGERY. (a) On application by either the employee or the
insurance carrier, the commission by order may extend the 104-week
period described by Section 401.011(30)(B) if the employee has had
spinal surgery, or has been approved for spinal surgery under
Section 408.026 and commission rules, within 12 weeks before the
expiration of the 104-week period. If an order is issued under
this section, the order shall extend the statutory period for
maximum medical improvement to a date certain, based on medical
evidence presented to the commission.
(b) Either the employee or the insurance carrier may dispute
an application for extension made under this section. A dispute
under this subsection is subject to Chapter 410.
(c) The commission shall adopt rules to implement this
section, including rules establishing procedures for requesting and
disputing an extension.
SECTION 6. Section 407.103(a), Labor Code, is amended to
read as follows:
(a) Each certified self-insurer shall pay a self-insurer
maintenance tax for the administration of the commission and to
support the prosecution of workers' compensation insurance fraud in
this state. Not more than two percent of the total tax base of all
certified self-insurers, as computed under Subsection (b), may be
assessed for a maintenance tax under this section. Out of this
amount, and in addition to the amounts assessed to pay the costs of
administration, an amount not to exceed one-tenth of one percent of
the total tax base of all certified self-insurers shall be assessed
annually to support the prosecution of workers' compensation
insurance fraud.
SECTION 7. Section 409.042(b), Labor Code, is amended to
read as follows:
(b) To be eligible for designation as an ombudsman, a person
must:
(1) demonstrate satisfactory knowledge of the
requirements of:
(A) this subtitle and the provisions of Subtitle
C that relate to claims management;
(B) other laws relating to workers'
compensation; and
(C) rules adopted under this subtitle and the
laws described under Subdivision (1)(B);
(2) have demonstrated experience in handling and
resolving problems for the general public;
(3) possess strong interpersonal skills; and
(4) have at least one year <three years> of
demonstrated experience in the field of workers' compensation.
SECTION 8. Subchapter B, Chapter 415, Labor Code, is amended
by adding Section 415.024 to read as follows:
Sec. 415.024. BREACH OF SETTLEMENT AGREEMENT; ADMINISTRATIVE
VIOLATION. A breach of a settlement agreement that establishes a
compliance plan is an administrative violation punishable by an
administrative penalty not to exceed $50,000. In determining the
amount of the penalty, the commission shall consider the total
volume of claims handled by the insurance carrier.
SECTION 9. (a) This Act takes effect September 1, 1997.
(b) The change in law made by Section 415.024, Labor Code,
as added by this Act, applies only to a violation that occurs on or
after the effective date of this Act. A violation that occurs
before the effective date of this Act is governed by the law in
effect on the date the violation occurred, and the former law is
continued for that purpose.
(c) The change in law made by this Act applies only to a
claim for workers' compensation benefits based on a compensable
injury that occurs on or after the effective date of this Act. A
claim based on a compensable injury that occurs before that date is
governed by the law in effect on the date that the compensable
injury occurred, and the former law is continued in effect for that
purpose.
SECTION 10. The importance of this legislation and the
crowded condition of the calendars in both houses create an
emergency and an imperative public necessity that theconstitutional
rule requiring bills to be read on three several days in each house
be suspended, and this rule is hereby suspended.