Bill not drafted by TLC or Senate E&E.
Line and page numbers may not match official copy.
By Rhodes H.B. No. 3522
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the administration and enforcement of the workers'
1-3 compensation law; providing penalties.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Section 401.011(30), Labor Code, is amended to
1-6 read as follows:
1-7 (30) "Maximum medical improvement" means the earlier
1-8 of:
1-9 (A) the earliest date after which, based on
1-10 reasonable medical probability, further material recovery from or
1-11 lasting improvement to an injury can no longer reasonably be
1-12 anticipated; [or]
1-13 (B) the expiration of 104 weeks from the date on
1-14 which income benefits begin to accrue; or
1-15 (C) that date that a condition is medically
1-16 stabilized if the injured employee has had surgery not later than
1-17 six weeks after the date computed under Paragraph (b), subject to
1-18 the commission's discretion.
1-19 SECTION 2. Section 402.011, Labor Code, is amended by
1-20 amending Subsection (b) and adding Subsections (c) and (d) to read
1-21 as follows:
1-22 (b) A member is entitled to reimbursement for actual lost
1-23 wages, if any, for:
1-24 (1) [due to] attendance at commission meetings, not to
2-1 exceed one day in each calendar quarter;
2-2 (2) preparation for a commission meeting, not to
2-3 extend two days in each calendar quarter;
2-4 (3) attendance at a subcommittee meeting, not to
2-5 exceed one day each month;
2-6 (4) attendance by the chair or vice chair of the
2-7 commission at a legislative committee meeting if attendance is
2-8 requested by the committee chair; and
2-9 (5) attendance at a meeting by a member appointed to
2-10 the Research and Oversight Council on Workers' Compensation or the
2-11 Texas Certified Self-Insured Guarantee Association.
2-12 (c) Reimbursement under Subsection (b) [this subsection] may
2-13 not exceed $100 a day and $12,000 a year.
2-14 (d) A member of the commission is entitled to reimbursement
2-15 for actual and necessary expenses for attendance at not more than
2-16 10 seminars in a calendar year if:
2-17 (1) the member is invited as a representative of the
2-18 commission to participate in a program offered at the seminar; and
2-19 (2) the member's participation is approved by the
2-20 chair of the commission.
2-21 SECTION 3. Section 403.002(a), Labor Code, is amended to
2-22 read as follows:
2-23 (a) Each insurance carrier, other than a governmental
2-24 entity, shall pay an annual maintenance tax to pay the costs of
2-25 administering this subtitle[.] and to support the prosecution of
2-26 workers' compensation insurance fraud in this state.
2-27 (b) The assessment may not exceed an amount equal to two
2-28 percent of the correctly reported gross workers' compensation
2-29 insurance premiums. Out of this amount, and in addition to the
2-30 amounts assessed to pay the costs of administration, an amount not
3-1 to exceed one-tenth of one percent of correctly reported gross
3-2 premiums shall be assessed annually to support the prosecution of
3-3 workers' compensation insurance fraud.
3-4 SECTION 4. Section 403.003(a), Texas Labor Code, is amended
3-5 to read as follows:
3-6 (a)(3) a surplus or deficit produced by the tax in the
3-7 preceding year; [and]
3-8 (a)(4) revenue recovered from other sources, including
3-9 reappropriated receipts, grants, payments, fees, gifts, and
3-10 penalties recovered under this subtitle; and
3-11 (a)(5) expenditures projected as necessary to support the
3-12 prosecution of workers' compensation insurance fraud.
3-13 SECTION 5. Section 408.123, Labor Code, is amended by adding
3-14 Subsection (d) to read as follows:
3-15 (d) The commission shall adopt rules that prescribe the
3-16 method of determining maximum medical improvement under Section
3-17 401.011(30)(C) and the criteria for determining whether a specific
3-18 injured employee is subject to that provision.
3-19 SECTION 6. Section 407.103(a), Labor Code, is amended to
3-20 read as follows:
3-21 (a) Each certified self-insurer shall pay a self insurer
3-22 maintenance tax for the administration of the commission and to
3-23 support the prosecution of workers' compensation insurance fraud in
3-24 this state. Not more than two-percent of the total tax base of all
3-25 certified self insurers, as computed under Subsection (b), may be
3-26 assessed for a maintenance tax under this section. Out of this
3-27 amount, and in addition to the amounts assessed to pay the costs of
3-28 administration, an amount not to exceed one-tenth of one percent of
3-29 the total tax base of all certified self-insurers shall be assessed
3-30 annually to support the prosecution of workers' compensation
4-1 insurance fraud.
4-2 SECTION 8. Section 409.042(b), Labor Code, is amended to
4-3 read as follows:
4-4 (b) To be eligible for designation as an ombudsman, a person
4-5 must:
4-6 (1) demonstrate satisfactory knowledge of the
4-7 requirements of:
4-8 (A) this subtitle and the provisions of Subtitle
4-9 C that relate to claims management;
4-10 (B) other laws relating to workers'
4-11 compensation; and
4-12 (C) rules adopted under this subtitle and the
4-13 laws described under Subdivision (1)(B);
4-14 (2) have demonstrated experience in handling and
4-15 resolving problems for the general public;
4-16 (3) possesses strong interpersonal skills; and
4-17 (4) have at least [three years] one year of
4-18 demonstrated experience in the field of workers' compensation.
4-19 SECTION 9. Section 415.024, Labor Code, is added to read as
4-20 follows:
4-21 Sec. 415.024. A breach of a settlement agreement that
4-22 establishes a compliance plan is an administrative violation
4-23 punishable by an administrative penalty not to exceed $50,000. In
4-24 determining the amount of the penalty, the commission shall
4-25 consider the total volume of claims handled by the insurance
4-26 carrier.
4-27 SECTION 10. (a) This Act takes effect September 1, 1997.
4-28 (b) The change in law made by this Act to Sections 414.004
4-29 and 415.024, Labor Code, applies only to a violation that occurs on
4-30 or after the effective date of this Act. A violation that occurs
5-1 before the effective date of this Act is governed by the law in
5-2 effect on the date the violation occurred, and the former law is
5-3 continued for that purpose.
5-4 (c) The change in law made by this Act to Sections
5-5 401.011(30) and 408.123, Labor Code, applies only to a claim for
5-6 benefits filed with the Texas Workers' Compensation Commission on
5-7 or after the effective date of this Act. A claim for benefits
5-8 filed before the effective date of this Act is governed by the law
5-9 in effect on the date the claim was filed, and the former law is
5-10 continued in effect for that purpose.
5-11 SECTION 11. The importance of this legislation and the
5-12 crowded condition of the calendars in both houses create an
5-13 emergency and an imperative public necessity that the
5-14 constitutional rule requiring bills to be read on three several
5-15 days in each house be suspended, and this rule is hereby suspended.