1-1     By:  Brimer, et al. (Senate Sponsor - Duncan)         H.B. No. 2600
 1-2           (In the Senate - Received from the House April 26, 2001;
 1-3     April 27, 2001, read first time and referred to Committee on
 1-4     Business and Commerce; May 11, 2001, reported favorably by the
 1-5     following vote:  Yeas 4, Nays 1; May 11, 2001, sent to printer.)
 1-6                            A BILL TO BE ENTITLED
 1-7                                   AN ACT
 1-8     relating to the provision of workers' compensation benefits and to
 1-9     the operation of the workers' compensation insurance system;
1-10     providing penalties.
1-11           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-12                ARTICLE 1.  APPROVED DOCTORS; MEDICAL REVIEW
1-13           SECTION 1.01. Subchapter B, Chapter 408, Labor Code, is
1-14     amended by amending Section 408.023 and adding Section 408.0231 to
1-15     read as follows:
1-16           Sec. 408.023.  LIST OF APPROVED DOCTORS; DUTIES OF TREATING
1-17     DOCTORS. (a)  The commission shall develop a list of doctors
1-18     licensed in this state who are approved to provide health care
1-19     services under this subtitle.  Each doctor licensed in this state
1-20     on September 1, 2001, [January 1, 1993,] is eligible to be included
1-21     on the commission's list of approved doctors if the doctor:
1-22                 (1)  registers with the commission in the manner
1-23     prescribed by commission rules; and
1-24                 (2)  complies with the requirements adopted by the
1-25     commission under this section.
1-26           (b)  The commission by rule shall establish reasonable
1-27     requirements for doctors and health care providers financially
1-28     related to those doctors regarding training, impairment rating
1-29     testing, and disclosure of financial interests as required by
1-30     Section 413.041, and for monitoring of those doctors and health
1-31     care providers as provided by Sections 408.0231 and 413.0512.  The
1-32     commission by rule shall provide a reasonable period, not to exceed
1-33     18 months after the adoption of rules under this section, for
1-34     doctors to comply with the registration and training requirements
1-35     of this subchapter.  Except as otherwise provided by this section,
1-36     the requirements under this subsection apply to doctors and health
1-37     care providers who:
1-38                 (1)  provide health care services as treating doctors;
1-39                 (2)  provide health care services as authorized by
1-40     Section 408.004 or 408.122;
1-41                 (3)  perform medical peer review under this subtitle;
1-42                 (4)  perform utilization review of medical benefits
1-43     provided under this subtitle; or
1-44                 (5)  provide health care services on referral from a
1-45     treating doctor, as provided by commission rule.
1-46           (c)  The commission shall issue to a doctor who is approved
1-47     by the commission a certificate of registration.  In determining
1-48     whether to issue a certificate of registration, the commission may
1-49     consider and condition its approval on any practice restrictions
1-50     applicable to the applicant that are relevant to services provided
1-51     under this subtitle.  The commission may also consider the practice
1-52     restrictions of an applicant when determining appropriate sanctions
1-53     under Section 408.0231.
1-54           (d)  A certificate of registration issued under this
1-55     subsection is valid, unless revoked or revised, for the period
1-56     provided by commission rule, and may be renewed on application to
1-57     the commission.   The commission shall provide notice to each
1-58     doctor on the approved doctor list of the pending expiration of the
1-59     doctor's certificate of registration not later than the 60th day
1-60     before the date of expiration of the certificate [unless
1-61     subsequently deleted and not reinstated.  The name of a doctor
1-62     shall be placed on the list of approved doctors when that doctor
1-63     becomes licensed in this state].
1-64           (e)  Notwithstanding other provisions of this section, a [A]
 2-1     doctor not licensed in this state but licensed in another state or
 2-2     jurisdiction who treats employees or performs utilization review of
 2-3     health care for an insurance carrier may apply for a certificate of
 2-4     registration under this section [to the commission] to be included
 2-5     on the commission's list of approved doctors.
 2-6           (f)  Except in an emergency or for immediate post-injury
 2-7     medical care as defined by commission rule, or as provided by
 2-8     Subsection (h) or (i), each doctor who performs functions under
 2-9     this subtitle, including examinations under Sections 408.004 and
2-10     408.122, must hold a certificate of registration and be on the list
2-11     of approved doctors in order to perform services or receive payment
2-12     for those services.
2-13           (g)  The commission by rule shall modify registration and
2-14     training requirements for doctors who infrequently provide health
2-15     care, perform utilization review or peer review functions for
2-16     insurance carriers, or participate in regional networks established
2-17     under this subchapter, as necessary to ensure that those doctors
2-18     are informed of the regulations that effect health care benefit
2-19     delivery under this subtitle.
2-20           (h)  Notwithstanding Section 4(h), Article 21.58A, Insurance
2-21     Code, a utilization review agent that uses doctors to perform
2-22     reviews of health care services provided under this subtitle shall
2-23     perform the reviews under the direction of a doctor licensed to
2-24     practice in this state.
2-25           (i)  The commission may grant exceptions to the requirement
2-26     imposed under Subsection (f) as necessary to ensure that:
2-27                 (1)  employees have access to health care; and
2-28                 (2)  insurance carriers have access to evaluations of
2-29     an employee's health care and income benefit eligibility as
2-30     provided by this subtitle.
2-31           (j)  The injured employee's treating doctor is responsible
2-32     for the efficient management of medical care as required by Section
2-33     408.025(c) and commission rules.  The commission shall collect
2-34     information regarding:
2-35                 (1)  return-to-work outcomes;
2-36                 (2)  patient satisfaction; and
2-37                 (3)  cost and utilization of health care provided or
2-38     authorized by a treating doctor on the list of approved doctors.
2-39           (k)  The commission may adopt rules to define the role of the
2-40     treating doctor and to specify outcome information to be collected
2-41     for a treating doctor.
2-42           Sec. 408.0231.  MAINTENANCE OF LIST OF APPROVED DOCTORS;
2-43     SANCTIONS AND PRIVILEGES RELATING TO HEALTH CARE. (a)  The
2-44     executive director shall delete from the list of approved doctors a
2-45     doctor:
2-46                 (1)  who is deceased;
2-47                 (2)  whose license to practice in this state is revoked
2-48     or suspended by the appropriate licensing authority; or
2-49                 (3)  who requests to be removed from the list.
2-50           (b)  The commission by rule shall establish criteria for:
2-51                 (1)  deleting a doctor from the list of approved
2-52     doctors;
2-53                 (2)  imposing sanctions on a doctor or an insurance
2-54     carrier as provided by this section;
2-55                 (3)  monitoring of utilization review agents, as
2-56     provided by a memorandum of understanding between the commission
2-57     and the Texas Department of Insurance; and
2-58                 (4)  authorizing increased or reduced utilization
2-59     review and preauthorization controls on a doctor.
2-60           (c)  Rules adopted under Subsection (b) are in addition to,
2-61     and do not affect, the rules adopted under Section 415.023(b).  The
2-62     criteria for deleting a doctor from the list or for recommending or
2-63     imposing sanctions may include anything the commission considers
2-64     relevant, including:
2-65                 (1)  a sanction [sanctions] of the doctor by the
2-66     commission for a violation [violations] of Chapter 413 or Chapter
2-67     415;
2-68                 (2)  a sanction [sanctions] by the Medicare or Medicaid
2-69     program for:
 3-1                       (A)  substandard medical care;
 3-2                       (B)  overcharging; [or]
 3-3                       (C)  overutilization of medical services; or
 3-4                       (D)  any other substantive noncompliance with
 3-5     requirements of those programs regarding professional practice or
 3-6     billing;
 3-7                 (3)  evidence from the commission's medical records
 3-8     that the applicable insurance carrier's utilization review
 3-9     practices or the doctor's charges, fees, diagnoses, [or]
3-10     treatments, evaluations, or impairment ratings are substantially
3-11     different from those the commission finds to be fair and reasonable
3-12     based on either a single determination or a pattern of practice;
3-13     [and]
3-14                 (4)  a suspension or other relevant practice
3-15     restriction of the doctor's license by an [the] appropriate
3-16     licensing authority;
3-17                 (5)  professional failure to practice medicine or
3-18     provide health care, including chiropractic care,  in an acceptable
3-19     manner consistent with the public health, safety, and welfare;
3-20                 (6)  findings of fact and conclusions of law made by a
3-21     court, an administrative law judge of the State Office of
3-22     Administrative Hearings, or a licensing or regulatory authority; or
3-23                 (7)  a criminal conviction.
3-24           (d) [(c)]  The commission by rule shall establish procedures
3-25     under which [for] a doctor may [to] apply for:
3-26                 (1)  reinstatement to the list of approved doctors; or
3-27                 (2)  restoration of doctor practice privileges removed
3-28     by the commission based on sanctions imposed under this section.
3-29           (e)  The commission shall act on a recommendation by the
3-30     medical advisor selected under Section 413.0511, and, after notice
3-31     and the opportunity for a hearing, may impose sanctions under this
3-32     subsection on a doctor or an insurance carrier or may recommend
3-33     action regarding a utilization review agent.  The commission and
3-34     the Texas Department of Insurance shall enter into a memorandum of
3-35     understanding to coordinate the regulation of insurance carriers
3-36     and utilization review agents as necessary to ensure:
3-37                 (1)  compliance with applicable regulations; and
3-38                 (2)  that appropriate health care decisions are reached
3-39     under this subtitle and under Article 21.58A, Insurance Code.
3-40           (f)  The sanctions the commission may recommend or impose
3-41     under this section include:
3-42                 (1)  reduction of allowable reimbursement;
3-43                 (2)  mandatory preauthorization of all or certain
3-44     health care services;
3-45                 (3)  required peer review monitoring and audit;
3-46                 (4)  deletion from the approved doctor list and the
3-47     designated doctor list;
3-48                 (5)  restrictions on appointment as a designated doctor
3-49     under Section 408.004;
3-50                 (6)  conditions or restrictions on an insurance carrier
3-51     regarding actions by insurance carriers under this subtitle in
3-52     accordance with the memorandum of understanding adopted between the
3-53     commission and the Texas Department of Insurance regarding Article
3-54     21.58A, Insurance Code; and
3-55                 (7)  mandatory participation in training classes or
3-56     other courses as established or certified by the commission.
3-57           SECTION 1.02. Subchapter E, Chapter 413, Labor Code, is
3-58     amended by amending Section 413.051 and adding Sections 413.0511,
3-59     413.0512, and 413.0513 to read as follows:
3-60           Sec. 413.051.  CONTRACTS WITH REVIEW ORGANIZATIONS AND HEALTH
3-61     CARE PROVIDERS. (a)  The commission may contract with a health care
3-62     provider, health care provider professional review organization, or
3-63     other entity to develop, maintain, or review medical policies or
3-64     fee guidelines or to review compliance with the medical policies or
3-65     fee guidelines.
3-66           (b)  For purposes of review or resolution of a dispute as to
3-67     compliance with the medical policies or fee guidelines, the
3-68     commission may contract [only] with a health care provider, health
3-69     care provider professional review organization, or other entity
 4-1     that includes in the review process health care practitioners who
 4-2     are licensed in the category under review and are of the same field
 4-3     or specialty as the category under review.
 4-4           (c)  The commission may contract with a health care provider,
 4-5     health care provider professional review organization, or other
 4-6     entity for medical consultant services, including:
 4-7                 (1)  independent medical examinations;
 4-8                 (2)  medical case reviews; or
 4-9                 (3)  establishment of medical policies and fee
4-10     guidelines.
4-11           (d)  The commission shall establish standards for contracts
4-12     under this section.
4-13           (e)  For purposes of this section, the term "health care
4-14     provider professional review organization" includes an independent
4-15     review organization.
4-16           Sec. 413.0511.  MEDICAL ADVISOR. (a)  The commission shall
4-17     employ or contract with a medical advisor, who must be a doctor as
4-18     that term is defined by Section 401.011.
4-19           (b)  The medical advisor shall make recommendations regarding
4-20     the adoption of rules to:
4-21                 (1)  develop, maintain, and review health care
4-22     guidelines and fee guidelines as provided by Section 413.011,
4-23     including rules regarding impairment ratings;
4-24                 (2)  review compliance with those guidelines;
4-25                 (3)  regulate other acts related to medical benefits as
4-26     required by the commission;
4-27                 (4)  impose sanctions or delete doctors from the
4-28     commission's list of approved doctors under Section 408.023 for:
4-29                       (A)  any reason described by Section 408.0231; or
4-30                       (B)  noncompliance with commission rules;
4-31                 (5)  impose conditions or restrictions as authorized by
4-32     Section 408.0231(f);
4-33                 (6)  receive confidential information from the Texas
4-34     State Board of Medical Examiners and the Texas Board of
4-35     Chiropractic Examiners regarding disciplinary actions imposed on a
4-36     physician or a chiropractor who applies for registration or is
4-37     registered with the commission on the list of approved doctors; and
4-38                 (7)  determine minimal modifications to the
4-39     reimbursement methodology and model used by the Medicare system as
4-40     necessary to meet occupational injury requirements.
4-41           Sec. 413.0512.  MEDICAL QUALITY REVIEW PANEL. (a)  The
4-42     medical advisor shall establish a medical quality review panel of
4-43     health care providers to assist the medical advisor in performing
4-44     the duties required under Section 413.0511.  The panel is
4-45     independent of the medical advisory committee created under Section
4-46     413.005 and is not subject to Chapter 2110, Government Code.
4-47           (b)  The Texas State Board of Medical Examiners and the Texas
4-48     Board of Chiropractic Examiners, with input from their respective
4-49     professional associations, shall develop lists of physicians and
4-50     chiropractors licensed by those agencies who have demonstrated
4-51     experience in workers' compensation or utilization review. The
4-52     medical advisor shall consider appointing some of the members of
4-53     the medical quality review panel from the names on those lists.
4-54     The medical advisor may also consider nominations for the panel
4-55     made by labor, business, and insurance organizations.
4-56           (c)  The medical quality review panel shall recommend to the
4-57     medical advisor:
4-58                 (1)  appropriate action regarding doctors, health care
4-59     providers, insurance carriers, and utilization review agents; and
4-60                 (2)  the addition or deletion of doctors from the list
4-61     of approved doctors under Section 408.023 or the list of designated
4-62     doctors established under Section 408.122.
4-63           (d)  A person who serves on the medical quality review panel
4-64     is not liable in a civil action for an act performed in good faith
4-65     as a member of the panel and is entitled to the same protections
4-66     afforded a commission member under Section 402.010.
4-67           (e)  The actions of a person serving on the medical quality
4-68     review panel do not constitute utilization review and are not
4-69     subject to Article 21.58A, Insurance Code.
 5-1           Sec. 413.0513.  CONFIDENTIALITY REQUIREMENTS. (a)
 5-2     Information maintained by or on behalf of the commission under
 5-3     Section 413.0512, and that is confidential under law, may not be
 5-4     disclosed under Section 413.0512 except:
 5-5                 (1)  in a criminal proceeding;
 5-6                 (2)  in a hearing conducted by or on behalf of the
 5-7     commission;
 5-8                 (3)  in a hearing conducted by another licensing or
 5-9     regulatory authority, as provided in the interagency agreement; or
5-10                 (4)  on a finding of good cause in an administrative or
5-11     judicial proceeding involving the enforcement of this subtitle or
5-12     in a disciplinary action under this subtitle.
5-13           (b)  Confidential information developed by the commission
5-14     under Section 413.0512 is not subject to discovery or court
5-15     subpoena in any action other than:
5-16                 (1)  an action to enforce this subtitle brought by the
5-17     commission, an appropriate licensing or regulatory agency, or an
5-18     appropriate enforcement authority; or
5-19                 (2)  a criminal proceeding.
5-20           SECTION 1.03. (a)  The Texas Workers' Compensation Commission
5-21     shall adopt rules as required by Chapter 408, Labor Code, as
5-22     amended by this article, not later than February 1, 2002.
5-23           (b)  A doctor is not required to hold a certificate of
5-24     registration issued under Section 408.023, Labor Code, as amended
5-25     by this article,  to perform medical services under Subtitle A,
5-26     Title 5, Labor Code, before the date provided by commission rules
5-27     adopted to implement that section.
5-28               ARTICLE 2. MEDICAL NETWORK PARTICIPATION OPTION
5-29           SECTION 2.01. Subchapter B, Chapter 408, Labor Code, is
5-30     amended by adding Sections 408.0221, 408.0222, and 408.0223 to read
5-31     as follows:
5-32           Sec. 408.0221.  REGIONAL HEALTH CARE DELIVERY NETWORKS;
5-33     ADVISORY COMMITTEE. (a)  In this section:
5-34                 (1)  "Advisory committee" means the Health Care Network
5-35     Advisory Committee.
5-36                 (2)  "Regional network" means a regional workers'
5-37     compensation health care delivery network established by the
5-38     commission under this section.
5-39           (b)  The Health Care Network Advisory Committee is
5-40     established to advise the commission on the implementation of this
5-41     section and Section 408.0222.  Members of the advisory committee
5-42     are appointed by and serve at the pleasure of the governor, with
5-43     the membership as follows:
5-44                 (1)  three employee representatives recommended by a
5-45     recognized statewide labor federation;
5-46                 (2)  three employer representatives;
5-47                 (3)  two ex officio insurance carrier representatives;
5-48                 (4)  two ex officio health care provider
5-49     representatives; and
5-50                 (5)  the commission's medical advisor, who shall serve
5-51     as chair of the advisory committee.
5-52           (c)  The commission, on behalf of the advisory committee
5-53     established under this section, shall establish and, through
5-54     competitive procurement, contract with regional networks for the
5-55     provision of health care under this subtitle.  The commission
5-56     shall, through competitive procurement, contract with one or more
5-57     organizations to determine the feasibility of, develop, and
5-58     evaluate the regional networks established under this section.
5-59     Those organizations shall also recommend to the advisory committee
5-60     appropriate network standards and application requirements and
5-61     assist the advisory committee during the procurement process. The
5-62     regional networks shall be fee-for-service networks designed to
5-63     improve the quality and reduce the cost of health care with active
5-64     health care management and monitoring and a full range of health
5-65     care services under contract as considered feasible by the
5-66     commission.
5-67           (d)  The advisory committee shall make recommendations to the
5-68     commission regarding:
5-69                 (1)  the development of the standards by which health
 6-1     care services are provided through regional networks;
 6-2                 (2)  regional network application requirements and
 6-3     fees;
 6-4                 (3)  contract proposals;
 6-5                 (4)  the feasibility of establishing one or more
 6-6     regional networks using a phased implementation and evaluation
 6-7     process;
 6-8                 (5)  the use of consultants as necessary to assist the
 6-9     commission in the procurement of regional network contracts; and
6-10                 (6)  the selection of administrators to build and
6-11     manage the regional networks and to report on their progress.
6-12           (e)  The advisory committee shall gather information from
6-13     other entities, including the Research and Oversight Council on
6-14     Workers' Compensation, the Texas Health Care Information Council,
6-15     the Texas Department of Insurance, the Texas Department of Health,
6-16     and the Employees Retirement System of Texas.
6-17           (f)  The standards adopted for preferred provider networks
6-18     under Article 3.70-3C, Insurance Code, as added by Chapter 1024,
6-19     Acts of the 75th Legislature, Regular Session, 1997, apply as
6-20     minimum standards for regional health care delivery networks
6-21     created under this section and are adopted by reference in this
6-22     section except to the extent they are inconsistent with this
6-23     subtitle.  The advisory committee may also recommend additional
6-24     standards, including standards that require:
6-25                 (1)  for each geographic region, access to an adequate
6-26     number of health care providers and treating doctors in each health
6-27     care discipline and the professional specialties within those
6-28     disciplines and the use of economic profiling to ensure a viable
6-29     network as described by Article 3.70-3C, Insurance Code, as added
6-30     by Chapter 1024, Acts of the 75th Legislature, Regular Session,
6-31     1997;
6-32                 (2)  the ability of an employee to receive treatment by
6-33     a regional network provider within a reasonable amount of time of
6-34     the regional network's knowledge of the need or request for
6-35     treatment and within a reasonable travel distance for the employee;
6-36                 (3)  a reasonable effort by the regional network to
6-37     attract health care providers who reflect the ethnic and cultural
6-38     background of the regional employee population;
6-39                 (4)  the availability of board-certified occupational
6-40     medicine specialists to provide expertise on disability management
6-41     and prevention and treatment of occupational injuries and
6-42     illnesses;
6-43                 (5)  accreditation of the regional networks or a
6-44     commitment to seek accreditation from a nationally recognized
6-45     organization such as the American Accreditation HealthCare
6-46     Commission or the National Committee for Quality Assurance;
6-47                 (6)  the use of strict credentialing criteria by
6-48     regional networks in the selection and deselection of its health
6-49     care providers, including verification that the provider:
6-50                       (A)  is on the commission's list of approved
6-51     doctors, if the provider is required to be on that list;
6-52                       (B)  has not been sanctioned or made subject to
6-53     additional utilization review requirements by the commission;
6-54                       (C)  is not, at the time of selection, subject to
6-55     sanctions or substantive practice restrictions imposed by the
6-56     provider's licensing authority;
6-57                       (D)  has or is able to obtain practice
6-58     privileges, if required, at a participating hospital; and
6-59                       (E)  is covered by medical malpractice insurance
6-60     coverage as required by the regional network contract;
6-61                 (7)  satisfactory evidence of the regional network's
6-62     ability to comply with any financial requirements and ensure
6-63     delivery of services;
6-64                 (8)  compliance with ongoing training and educational
6-65     requirements established by the commission;
6-66                 (9)  the use of nationally recognized, scientifically
6-67     valid, and outcome-based treatment standards as guidelines for
6-68     health care;
6-69                 (10)  disclosure of the availability of interpreter
 7-1     services as appropriate for the evaluation and treatment of
 7-2     employees;
 7-3                 (11)  timely and accurate reporting of data to
 7-4     appropriately manage and determine the effectiveness of the
 7-5     regional network in reducing medical costs and ensuring quality of
 7-6     care; and
 7-7                 (12)  a process for reconsideration of medical
 7-8     necessity denials and resolution of medical necessity disputes
 7-9     within the regional network.
7-10           (g)  The advisory committee and the Research and Oversight
7-11     Council on Workers' Compensation shall develop evaluation standards
7-12     and specifications as necessary to implement a workers'
7-13     compensation medical regional network report card.  The commission
7-14     shall ensure that the report card is published and available for
7-15     inspection.  The commission may procure services as necessary to
7-16     produce the report card.  The report card, at a minimum, must be
7-17     based on contracted reviews and must include a risk-adjusted
7-18     evaluation of:
7-19                 (1)  employee access to care;
7-20                 (2)  coordination of care and return to work;
7-21                 (3)  communication among system participants;
7-22                 (4)  return-to-work outcomes;
7-23                 (5)  health-related outcomes;
7-24                 (6)  employee, health care provider, employer, and
7-25     insurance carrier satisfaction;
7-26                 (7)  disability and re-injury prevention;
7-27                 (8)  appropriate clinical care;
7-28                 (9)  health care costs;
7-29                 (10)  utilization of health care; and
7-30                 (11)  statistical outcomes of medical dispute
7-31     resolution provided by independent review organizations.
7-32           (h)  The regional network administrators shall report
7-33     quarterly to the commission and the advisory committee on the
7-34     progress of implementing the regional networks and shall submit
7-35     consolidated annual reports.  The Research and Oversight Council on
7-36     Workers' Compensation shall report to the legislature by January 1
7-37     of each odd-numbered year on the status of the implementation of
7-38     regional networks under this section.
7-39           (i)  The commission shall ensure that regional network
7-40     contracts provide that insurance carriers have reasonable rights to
7-41     conduct audits under this subsection.  Insurance carriers
7-42     participating in the regional network shall be allowed the
7-43     opportunity for consolidated audits of the regional networks.
7-44           (j)  The cost of assessing the feasibility of, developing,
7-45     and evaluating the regional networks created under this section
7-46     shall be funded through an assessment on the subsequent injury fund
7-47     established under Section 403.006.  This cost may not exceed
7-48     $250,000 per regional network or a total of $1.5 million for up to
7-49     six regional networks.  The cost of ongoing regional network
7-50     administration and management services shall be included in the
7-51     fees for health care services paid by insurance carriers
7-52     participating in the regional network.
7-53           Sec. 408.0222.  PARTICIPATION IN REGIONAL NETWORK; SELECTION
7-54     OF DOCTOR WITHIN REGIONAL NETWORK; BENEFIT INCENTIVES. (a)  An
7-55     insurance carrier or a self-insurer certified to provide workers'
7-56     compensation coverage in this state may elect to participate, by
7-57     contract, in a regional network established under Section 408.0221.
7-58     A public employer covered under Subtitle C of this title, other
7-59     than an employer covered under Chapter 504, is required to
7-60     participate in a regional network established under Section
7-61     408.0221.  An insurance carrier who elects to participate in
7-62     regional networks agrees to abide by the terms of the regional
7-63     network contracts between the commission and the regional networks.
7-64           (b)  An insurance carrier may limit its election to
7-65     participate in a regional network established under Section
7-66     408.0221 to a particular employer or a particular region of this
7-67     state.  This subsection expires January 1, 2006.
7-68           (c)  A doctor participating in a regional network established
7-69     under Section 408.0221 may perform only those procedures that are
 8-1     within the scope of the practice for which the doctor is licensed.
 8-2           (d)  An employee may elect to participate or not participate
 8-3     in a regional network established under Section 408.0221. Only an
 8-4     employee covered by an insurance carrier who has elected to
 8-5     participate in a regional network established under Section
 8-6     408.0221 may elect to participate in that regional network.  The
 8-7     commission, by rule, shall establish the form and manner by which
 8-8     an employee receives notice of the employee's rights under this
 8-9     section.  Except as provided by Subsection (e), an employee may
8-10     make the election described by this subsection at the time of
8-11     employment or may make that election or rescind an election made
8-12     under this subsection at any later time before the earlier of:
8-13                 (1)  the date on which the employee begins to receive
8-14     enhanced income benefits under Subsection (l); or
8-15                 (2)  the 14th day after the date on which the employee
8-16     incurs a compensable injury.
8-17           (e)  An employee may elect to participate in a regional
8-18     network established under Section 408.0221 at any time with the
8-19     insurance carrier's permission. An employee is not bound by an
8-20     election to participate in a  regional network made under
8-21     Subsection (d) or this subsection if:
8-22                 (1)  the insurance carrier waives the election;
8-23                 (2)  the commission invalidates the election based on a
8-24     determination of coercion; or
8-25                 (3)  the employee relocates to an area outside of the
8-26     regional network's service area, and the regional network is not
8-27     able to identify alternate network providers to provide health care
8-28     services reasonable for the employee's medical condition.
8-29           (f)  An insurance carrier who elects to participate in a
8-30     regional network established under Section 408.0221 shall provide
8-31     each employer who obtains coverage through the insurance carrier
8-32     with adequate information about the regional network to share with
8-33     the employer's employees. Before an employee makes an election
8-34     under this section to participate in a regional network, the
8-35     employer shall provide the employee with:
8-36                 (1)  a complete, plain-language description of the
8-37     regional network's services, restrictions, and benefits, including
8-38     a description of the enhanced income benefits that may be due; and
8-39                 (2)  access to the most recent:
8-40                       (A)  list of doctors  available through the
8-41     regional network; and
8-42                       (B)  regional network report card developed under
8-43     Section 408.0221.
8-44           (g)  An employer shall not discharge, subject to disciplinary
8-45     action, or take an adverse employment action against an employee
8-46     who elects not to participate in a regional network created under
8-47     Section 408.0221 if the employer's action would not have occurred
8-48     in the absence of the employee's election not to participate.
8-49           (h)  An employee may bring suit against an employer for
8-50     violation of Subsection (g) if:
8-51                 (1)  the employee gives written notice of intent to
8-52     bring suit to the employer within 60 days of the alleged violation;
8-53     and
8-54                 (2)  the employer does not reinstate the employee and
8-55     pay actual wages lost and reasonable attorney's fees incurred due
8-56     to the employer's action within 60 days of notification of the
8-57     employee's intent to bring suit.
8-58           (i)  The employee must bring suit for an employer's violation
8-59     of Subsection (g) within 120 days of the alleged violation.  A suit
8-60     under this section may be brought in the county in which:
8-61                 (1)  the plaintiff resides;
8-62                 (2)  the plaintiff was employed; or
8-63                 (3)  the defendant's primary place of business is
8-64     located.
8-65           (j)  If the employee prevails in an action under Subsection
8-66     (h), the employee may recover:
8-67                 (1)  lost wages;
8-68                 (2)  reinstatement of front pay as equitable relief in
8-69     lieu of reinstatement;
 9-1                 (3)  reasonable attorney's fees; and
 9-2                 (4)  court costs.
 9-3           (k)  A suit under this section is the exclusive remedy for
 9-4     violation of Subsection (g) and the provisions of Chapter 451 do
 9-5     not apply to such a violation.  Parties may not maintain an action
 9-6     under Rule 42, Texas Rules of Civil Procedure.
 9-7           (l)  An employee who elects to participate in a regional
 9-8     network created under Section 408.0221 shall receive:
 9-9                 (1)  notwithstanding Section 408.082(c), income
9-10     benefits from the date disability begins if the disability lasts
9-11     two weeks or longer; and
9-12                 (2)  notwithstanding Section 408.061, an increased
9-13     maximum weekly benefit of up to 150 percent of the state average
9-14     weekly wage for temporary income benefits.
9-15           (m)  Except for emergency care, or as otherwise provided by
9-16     this section, an employee who elects to participate in a regional
9-17     network shall receive medical treatment, including referrals, from
9-18     health care providers within the regional network.  An employee or
9-19     an employee's treating doctor may use a health care provider
9-20     outside of the regional network with the approval of the regional
9-21     network for good cause consistent with the regional network
9-22     contract.  If medically necessary services are not available
9-23     through regional network health care providers, the regional
9-24     network must, on the request of a regional network health care
9-25     provider, within a reasonable time period allow a referral to a
9-26     nonregional network health care provider and shall fully reimburse
9-27     the nonregional network physician or provider at an agreed rate.
9-28     For purposes of this subsection, "emergency care" has the meaning
9-29     assigned by Section 2(g), Texas Health Maintenance Organization Act
9-30     (Article 20A.02, Vernon's Texas Insurance Code).
9-31           (n)  A health care provider who participates in a regional
9-32     network created under Section 408.0221 shall be reimbursed and be
9-33     subject to utilization review as provided by the regional network
9-34     contract.  The insurance carrier is responsible for payment of
9-35     regional network providers as provided by the contract between the
9-36     regional network and the insurance carrier.  A nonregional network
9-37     provider who does not obtain the approval of the regional network
9-38     to provide services may not be reimbursed by the insurance carrier.
9-39           (o)  To resolve an issue regarding the necessity or the
9-40     appropriateness of care, or referrals to nonregional network
9-41     physicians or providers, an employee or an employee's treating
9-42     doctor may request a review by an independent review organization
9-43     under Section 413.031(c).
9-44           (p)  An employee who elects to participate in a regional
9-45     network established under Section 408.0221 shall select an initial
9-46     treating doctor within the regional network as provided by the
9-47     regional network contract.  An employee may change treating doctors
9-48     within the regional network in accordance with Sections 408.022(d)
9-49     and (e).  An employee who requests to change treating doctors
9-50     within the regional network is not subject to Section 408.022(b) or
9-51     (c).  At the sole discretion of the regional network, an employee
9-52     may select a treating doctor outside of the regional network if:
9-53                 (1)  the employee has a pre-existing relationship with
9-54     a doctor who maintains the employee's medical records and has a
9-55     documented history of treatment before the date of injury; and
9-56                 (2)  that doctor agrees in writing to abide by the
9-57     rules, terms, and conditions of the regional network contract,
9-58     including an agreement to refer the employee within the regional
9-59     network for services available through the regional network.
9-60           (q)  An employee is subject to the selection of doctor,
9-61     change of doctor, and other medical benefit and income benefit
9-62     requirements established under Chapters 408 and 413 if an employee:
9-63                 (1)  elects not to participate in a regional network
9-64     established under Section 408.0221; or
9-65                 (2)  is covered by an insurance carrier that has not
9-66     elected to participate in a regional network established under
9-67     Section 408.0221.
9-68           (r)  An employee may change treating doctors within the
9-69     regional network established under Section 408.0221 in which the
 10-1    employee is participating in accordance with the regional network
 10-2    contract and is entitled to:
 10-3                (1)  make one change from the initial treating doctor
 10-4    to an alternate treating doctor within the regional network unless
 10-5    the initial treating doctor has found that the employee has reached
 10-6    maximum medical improvement, in which case the commission shall
 10-7    appoint a designated doctor on the request of the employee as
 10-8    provided by Section 408.0041; and
 10-9                (2)  request additional changes of the treating doctor
10-10    in the manner provided by the regional network contract.
10-11          Sec. 408.0223.  INSURANCE CARRIER NETWORKS. (a)  In this
10-12    section, "insurance carrier network" means a voluntary workers'
10-13    compensation health care delivery network established by an
10-14    insurance carrier.  The term does not include a regional network
10-15    established under Section 408.0221.
10-16          (b)  This subtitle does not prohibit an insurance carrier,
10-17    whether doing business as an individual carrier or as a group, from
10-18    participating in or maintaining voluntary insurance carrier
10-19    networks if those voluntary insurance carrier networks allow
10-20    selection of doctors as provided by Section 408.022.
10-21          (c)  This subtitle does not prohibit an insurance carrier
10-22    from concurrently participating in an insurance carrier network and
10-23    a regional network established under Section 408.0221.
10-24          SECTION 2.02. (a)  The Texas Workers' Compensation Commission
10-25    shall adopt rules as required by Chapter 408, Labor Code, as
10-26    amended by this article, not later than October 1, 2002.
10-27          (b)  The Texas Workers' Compensation Commission shall convene
10-28    the first meeting of the Health Care Network Advisory Committee
10-29    established under Section 408.0221, Labor Code, as added by this
10-30    article, not later than October 1, 2001.
10-31          (c)  Unless determined to be unfeasible, the Texas Workers'
10-32    Compensation Commission shall contract for regional workers'
10-33    compensation health care delivery networks under Section 408.0221,
10-34    Labor Code, as added by this article, not later than December 31,
10-35    2002.
10-36          (d)  Section 408.0222, Labor Code, as added by this article,
10-37    as that section affects workers' compensation benefits an employee
10-38    may receive for participating in a regional network under Section
10-39    408.0221, Labor Code, as added by this article, takes effect on the
10-40    certification by the Texas Workers' Compensation Commission that
10-41    the regional network is operational.
10-42             ARTICLE 3.  RETURN-TO-WORK REPORTING AND SERVICES
10-43          SECTION 3.01. Section 409.005, Labor Code, is amended to read
10-44    as follows:
10-45          Sec. 409.005.  REPORT OF INJURY; MODIFIED DUTY PROGRAM
10-46    NOTICE; ADMINISTRATIVE VIOLATION. (a)  An employer shall report to
10-47    the employer's insurance carrier if:
10-48                (1)  an injury results in the absence of an employee of
10-49    that employer from work for more than one day; or
10-50                (2)  an employee of the employer notifies that employer
10-51    of an occupational disease under Section 409.001.
10-52          (b)  The report under Subsection (a)  must be made not later
10-53    than the eighth day after:
10-54                (1)  the employee's absence from work for more than one
10-55    day due to an injury; or
10-56                (2)  the day on which the employer receives notice
10-57    under Section 409.001 that the employee has contracted an
10-58    occupational disease.
10-59          (c)  The employer shall deliver a written copy of the report
10-60    under Subsection (a) to the injured employee at the time that the
10-61    report is made to the insurance carrier.
10-62          (d)  The insurance carrier shall file the report of the
10-63    injury on behalf of the policyholder.  Except as provided by
10-64    Subsection (e), the insurance carrier must electronically file the
10-65    report with the commission not later than the seventh day after the
10-66    date on which the carrier receives the report from the employer.
10-67          (e)  The executive director may waive the electronic filing
10-68    requirement under Subsection (d) and allow an insurance carrier to
10-69    mail or deliver the report to the commission not later than the
 11-1    seventh day after the date on which the carrier receives the report
 11-2    from the employer.
 11-3          (f)  A report required under this section may not be
 11-4    considered to be an admission by or evidence against an employer or
 11-5    an insurance carrier in a proceeding before the commission or a
 11-6    court in which the facts set out in the report are contradicted by
 11-7    the employer or insurance carrier.
 11-8          (g)  In addition to any information required under Subsection
 11-9    (h), the report provided to the injured employee under Subsection
11-10    (c) must contain a summary written in plain language of the
11-11    employee's statutory rights and responsibilities under this
11-12    subtitle.
11-13          (h)  The commission may adopt rules relating to:
11-14                (1)  the information that must be contained in a report
11-15    required under this section, including the summary of rights and
11-16    responsibilities required under Subsection (g); and
11-17                (2)  the development and implementation of an
11-18    electronic filing system for injury reports under this section.
11-19          (i)  An employer and insurance carrier shall file subsequent
11-20    reports as required by commission rule.
11-21          (j)  The employer shall, on the written request of the
11-22    employee, a  doctor, the insurance carrier, or the commission,
11-23    notify the employee, the employee's treating doctor if known to the
11-24    employer, and the insurance carrier of the existence or absence of
11-25    opportunities for modified duty or a modified duty return-to-work
11-26    program available through the employer.  If those opportunities or
11-27    that program exists, the employer shall identify the employer's
11-28    contact person and provide other information to assist the treating
11-29    doctor, the employee, and the insurance carrier to assess modified
11-30    duty or return-to-work options.
11-31          (k)  A person commits a violation if the person fails to
11-32    comply with this section unless good cause exists.  A violation
11-33    under this subsection is a Class D administrative violation.
11-34          SECTION 3.02. Subchapter B, Chapter 413, Labor Code, is
11-35    amended by adding Section 413.021 to read as follows:
11-36          Sec. 413.021.  RETURN-TO-WORK COORDINATION SERVICES. (a)  An
11-37    insurance carrier shall, with the agreement of a participating
11-38    employer, provide the employer with return-to-work coordination
11-39    services as necessary to facilitate an employee's reintegration to
11-40    employment.  The insurance carrier shall notify the employer of the
11-41    availability of return-to-work coordination services. In offering
11-42    the services, insurance carriers and the commission shall target
11-43    employers without return-to-work programs and shall focus
11-44    return-to-work efforts on workers who begin to receive temporary
11-45    income benefits.  These services may be offered by insurance
11-46    carriers in conjunction with the accident prevention services
11-47    provided under Section 411.061.  Nothing in this section supersedes
11-48    the provisions of a collective bargaining agreement between an
11-49    employer and the employer's employees, and nothing in this section
11-50    authorizes or requires an employer to engage in conduct that would
11-51    otherwise be a violation of the employer's obligations under the
11-52    National Labor Relations Act (29 U.S.C. Section 151 et seq.), and
11-53    its subsequent amendments.
11-54          (b)  Return-to-work coordination services under this section
11-55    may include:
11-56                (1)  job analysis to identify the physical demands of a
11-57    job;
11-58                (2)  job modification and restructuring assessments as
11-59    necessary to match job requirements with the functional capacity of
11-60    an employee; and
11-61                (3)  medical or vocational case management to
11-62    coordinate the efforts of the employer, the treating doctor, and
11-63    the injured employee to achieve timely return to work.
11-64          (c)  An insurance carrier is not required to provide physical
11-65    workplace modifications under this section and is not liable for
11-66    the cost of modifications made under this section to facilitate an
11-67    employee's return to employment.
11-68          (d)  The commission shall use certified rehabilitation
11-69    counselors or other appropriately trained or credentialed
 12-1    specialists to provide training to commission staff regarding the
 12-2    coordination of return-to-work services under this section.
 12-3          (e)  The commission shall adopt rules necessary to collect
 12-4    data on return-to-work outcomes to allow full evaluations of
 12-5    successes and of barriers to achieving timely return to work after
 12-6    an injury.
 12-7          (f)  The commission shall report twice annually to the
 12-8    Research and Oversight Council on Workers' Compensation regarding
 12-9    the implementation and outcome of the return-to-work initiatives
12-10    required by this section.
12-11          SECTION 3.03. The Texas Workers' Compensation Commission may
12-12    adopt rules as necessary to implement Sections 409.005(j) and
12-13    413.021, Labor Code, as added by this article, not earlier than
12-14    January 1, 2004.
12-15             ARTICLE 4.  PREAUTHORIZATION, CONCURRENT REVIEW,
12-16                      AND CERTIFICATION REQUIREMENTS
12-17          SECTION 4.01. Section 408.026, Labor Code, is amended to read
12-18    as follows:
12-19          Sec. 408.026.  SPINAL SURGERY [SECOND OPINION]. [(a)]  Except
12-20    in a medical emergency, an insurance carrier is liable for medical
12-21    costs related to spinal surgery only as provided by Section 413.014
12-22    and commission rules [if:]
12-23                [(1)  before surgery, the employee obtains from a
12-24    doctor approved by the insurance carrier or the commission a second
12-25    opinion that concurs with the treating doctor's recommendation;]
12-26                [(2)  the insurance carrier waives the right to an
12-27    examination or fails to request an examination before the 15th day
12-28    after the date of the notification that surgery is recommended; or]
12-29                [(3)  the commission determines that extenuating
12-30    circumstances exist and orders payment for surgery].
12-31          [(b)  The commission shall adopt rules necessary to ensure
12-32    that an examination required under this section is performed
12-33    without undue delay.]
12-34          SECTION 4.02. Section 413.014, Labor Code, is amended to read
12-35    as follows:
12-36          Sec. 413.014.  PREAUTHORIZATION REQUIREMENTS; CONCURRENT
12-37    REVIEW AND CERTIFICATION OF HEALTH CARE. (a)  In this section,
12-38    "investigational or experimental service or device" means a health
12-39    care treatment, service, or device for which there is early,
12-40    developing scientific or clinical evidence demonstrating the
12-41    potential efficacy of the treatment, service, or device but that is
12-42    not yet broadly accepted as the prevailing standard of care.
12-43          (b)  The commission by rule shall specify which health care
12-44    treatments and services require express preauthorization or
12-45    concurrent review by the insurance carrier. Treatments and services
12-46    for a medical emergency do not require express preauthorization.
12-47          (c)  The commission rules adopted under this section must
12-48    provide that preauthorization and concurrent review are required at
12-49    a minimum for:
12-50                (1)  spinal surgery, as provided by Section 408.026;
12-51                (2)  work-hardening or work-conditioning services
12-52    provided by a health care facility that is not credentialed by an
12-53    organization recognized by commission rules;
12-54                (3)  inpatient hospitalization, including any procedure
12-55    and length of stay;
12-56                (4)  outpatient or ambulatory surgery; and
12-57                (5)  any investigational or experimental services or
12-58    devices.
12-59          (d) [(b)]  The insurance carrier is not liable for those
12-60    specified treatments and services requiring preauthorization unless
12-61    preauthorization is sought by the claimant or health care provider
12-62    and either obtained from the insurance carrier or ordered by the
12-63    commission.
12-64          (e)  Each insurance carrier shall allow health care providers
12-65    to request that the insurance carrier prospectively or concurrently
12-66    certify coverage for health care services, including pharmaceutical
12-67    services, that do not require preauthorization and concurrent
12-68    review.  Regardless of the insurance carrier's response to the
12-69    request, the carrier retains the right to retrospectively review
 13-1    health care services and supporting records and to contest the
 13-2    certification of those services.
 13-3          SECTION 4.03. Subchapter B, Chapter 413, Labor Code, is
 13-4    amended by adding Section 413.0141 to read as follows:
 13-5          Sec. 413.0141.  INITIAL PHARMACEUTICAL COVERAGE. The
 13-6    commission may by rule provide that an insurance carrier shall
 13-7    provide for payment of specified pharmaceutical services sufficient
 13-8    for the first seven days following the date of injury if the health
 13-9    care provider requests and receives verification of insurance
13-10    coverage and a verbal confirmation of an injury from the employer
13-11    or from the insurance carrier as provided by Section 413.014.  The
13-12    rules adopted by the commission may also provide that an insurance
13-13    carrier is eligible for reimbursement for pharmaceutical services
13-14    paid under this section from the subsequent injury fund in the
13-15    event the injury is determined not to be compensable.
13-16          SECTION 4.04. The Texas Workers' Compensation Commission
13-17    shall adopt the rules required under Sections 408.026 and 413.014,
13-18    Labor Code, as amended or added by this article, not later than
13-19    February 1, 2002, and may adopt rules required by Section 413.0141,
13-20    Labor Code.
13-21       ARTICLE 5. REQUIRED MEDICAL EXAMINATIONS; DESIGNATED DOCTORS
13-22          SECTION 5.01. Sections 408.004(a) and (c), Labor Code, are
13-23    amended to read as follows:
13-24          (a)  The commission may require an employee to submit to
13-25    medical examinations to resolve any question about[:]
13-26                [(1)]  the appropriateness of the health care received
13-27    by the employee[;]
13-28                [(2)  the impairment caused by the compensable injury;]
13-29                [(3)  the attainment of maximum medical improvement; or]
13-30                [(4)  similar issues].
13-31          (c)  The insurance carrier shall pay for:
13-32                (1)  an examination required under Subsection (a) or
13-33    (b); and
13-34                (2)  the reasonable mileage expenses [expense] incident
13-35    to the employee in submitting to the examination.
13-36          SECTION 5.02.  Subchapter A, Chapter 408, Labor Code, is
13-37    amended by adding Section 408.0041 to read as follows:
13-38          Sec. 408.0041.  DESIGNATED DOCTOR EXAMINATION.  (a)  At the
13-39    request of an insurance carrier or an employee, the commission
13-40    shall order a medical examination to resolve any question about:
13-41                (1)  the impairment caused by the compensable injury;
13-42                (2)  the attainment of maximum medical improvement;
13-43                (3)  the ability of the employee to return to work;
13-44                (4)  the extent of the injury; or
13-45                (5)  similar issues.
13-46          (b)  A medical examination requested under Subsection (a)
13-47    shall be performed by the next available doctor on the commission's
13-48    list of designated doctors whose credentials are appropriate for
13-49    the issue in question and the injured employee's medical condition.
13-50    The designated doctor doing the review must be knowledgeable and
13-51    experienced with the treatment and procedures used by the doctor
13-52    treating the patient's medical condition and the treatments and
13-53    procedures performed must be within the scope of practice of the
13-54    designated doctor.  The commission shall assign a designated doctor
13-55    not later than the 10th day after the date on which the request
13-56    under Subsection (a) is received, and the examination must be
13-57    conducted not later than the 21st day after the date on which the
13-58    commission issues the order under Subsection (a).  An examination
13-59    under this section may not be held more frequently than every 60
13-60    days, unless good cause for more frequent examinations exists, as
13-61    defined by commission rules.
13-62          (c)  The treating doctor and the insurance carrier are both
13-63    responsible for sending to the designated doctor all of the injured
13-64    employee's medical records relating to the issue to be evaluated by
13-65    the designated doctor that are in their possession.  The treating
13-66    doctor and insurance carrier may send the records without a signed
13-67    release from the employee.  The designated doctor is authorized to
13-68    receive the employee's confidential medical records to assist in
13-69    the resolution of disputes.  The treating doctor and insurance
 14-1    carrier may also send the designated doctor an analysis of the
 14-2    injured worker's medical condition, functional abilities, and
 14-3    return-to-work opportunities.
 14-4          (d)  To avoid undue influence on a person selected as a
 14-5    designated doctor under this section, only the injured employee or
 14-6    an appropriate member of the staff of the commission may
 14-7    communicate with the designated doctor about the case regarding the
 14-8    injured employee's medical condition or history before the
 14-9    examination of the injured employee by the designated doctor.
14-10    After that examination is completed, communication with the
14-11    designated doctor regarding the injured employee's medical
14-12    condition or history may be made only through appropriate
14-13    commission staff members.  The designated doctor may initiate
14-14    communication with any doctor who has previously treated or
14-15    examined the injured employee for the work-related injury or with
14-16    peer reviewers identified by the insurance carrier.
14-17          (e)  The designated doctor shall report to the commission.
14-18    The report of the designated doctor has presumptive weight unless
14-19    the great weight of the evidence is to the contrary.  An employer
14-20    may make a bona fide offer of employment subject to Sections
14-21    408.103(e) and 408.144(c) based on the designated doctor's report.
14-22          (f)  If an insurance carrier is not satisfied with the
14-23    opinion rendered by a designated doctor under this section, the
14-24    insurance carrier may request the commission to order an employee
14-25    to attend an examination by a doctor selected by the insurance
14-26    carrier.  The commission shall allow the insurance carrier
14-27    reasonable time to obtain and present the opinion of the doctor
14-28    selected under this subsection before the commission makes a final
14-29    decision on the merits of the issue in question.
14-30          (g)  The insurance carrier shall pay for:
14-31                (1)  an examination required under Subsection (a); and
14-32                (2)  the reasonable expenses incident to the employee
14-33    in submitting to the examination.
14-34          (h)  An employee is not entitled to temporary income
14-35    benefits, and an insurance carrier may suspend the payment of
14-36    temporary income benefits, during and for a period in which the
14-37    employee fails to submit to an examination under Subsection (a) or
14-38    (b) unless the commission determines that the employee had good
14-39    cause for the failure to submit to the examination.  The commission
14-40    may order temporary income benefits to be paid for the period that
14-41    the commission determines the employee had good cause.  The
14-42    commission by rule shall ensure that an employee receives
14-43    reasonable notice of an examination and of the insurance carrier's
14-44    basis for suspension of payment and that the employee is provided a
14-45    reasonable opportunity to reschedule an examination missed by the
14-46    employee for good cause.
14-47          (i)  If the report of a designated doctor indicates that an
14-48    employee can return to work immediately or has reached maximum
14-49    medical improvement, the insurance carrier may suspend or reduce
14-50    the payment of temporary income benefits immediately.
14-51          (j)  If the report of a doctor selected by the insurance
14-52    carrier indicates that an employee can return to work immediately
14-53    or has reached maximum medical improvement, the insurance carrier
14-54    may suspend or reduce the payment of temporary income benefits on
14-55    the 14th day after the date on which the insurance carrier files a
14-56    notice of suspension with the commission.
14-57          (k)  At the request of the employee or the insurance carrier
14-58    to dispute a decision under Subsection (i) or (j), the commission
14-59    shall hold an expedited benefit review conference, by personal
14-60    appearance or by telephone, not later than the 10th day after the
14-61    date on which the commission receives the request for the
14-62    conference.  If a benefit review conference is not held by the 14th
14-63    day after the date on which the commission receives the insurance
14-64    carrier's notice of suspension, an interlocutory order, effective
14-65    from the date of the report certifying maximum medical improvement,
14-66    is automatically entered for the continuation of temporary income
14-67    benefits until a benefit review conference is held, and the
14-68    insurance carrier is eligible for reimbursement for any overpayment
14-69    of benefits as provided by Chapter 410.  The commission is not
 15-1    required to schedule a contested case hearing as required by
 15-2    Section 410.025(b) if a benefit review conference is scheduled
 15-3    under this subsection.  If a benefit review conference is held not
 15-4    later than the 14th day, the commission may enter an interlocutory
 15-5    order for the continuation of benefits and the insurance carrier is
 15-6    eligible for reimbursement for any overpayments of benefits as
 15-7    provided by Chapter 410.  The commission shall adopt rules as
 15-8    necessary to implement this subsection under which:
 15-9                (1)  an insurance carrier is required to notify the
15-10    employee and the treating doctor of the suspension of benefits
15-11    under this subsection by certified mail or another verifiable
15-12    delivery method;
15-13                (2)  the commission makes a reasonable attempt to
15-14    obtain the treating doctor's opinion before the commission makes a
15-15    determination regarding the entry of an interlocutory order; and
15-16                (3)  the commission may allow abbreviated contested
15-17    case hearings by personal appearance or telephone to consider
15-18    issues relating to overpayment of benefits under this section.
15-19          SECTION 5.03. Sections 408.122(b) and (c), Labor Code, are
15-20    amended to read as follows:
15-21          (b)  To be eligible to serve as a designated doctor, a doctor
15-22    must meet specific qualifications, including training in the
15-23    determination of impairment ratings.  The executive director shall
15-24    develop qualification standards and administrative policies to
15-25    implement this subsection, and the commission may adopt rules as
15-26    necessary.  The designated doctor doing the review must be
15-27    knowledgeable and experienced with the treatment and procedures
15-28    used by the doctor treating the patient's medical condition and the
15-29    treatments and procedures performed must be within the scope of
15-30    practice of the designated doctor.  A designated doctor's
15-31    credentials must be appropriate for the issue in question and the
15-32    injured employee's medical condition. [To the extent possible, a
15-33    designated doctor must be in the same discipline and licensed by
15-34    the same board of examiners as the employee's doctor of choice.]
15-35          (c)  [If a dispute exists as to whether the employee has
15-36    reached maximum medical improvement, the commission shall direct
15-37    the employee to be examined by a designated doctor chosen by mutual
15-38    agreement of the parties.  If the parties are unable to agree on a
15-39    designated doctor, the commission shall direct the employee to be
15-40    examined by a designated doctor chosen by the commission.  The
15-41    designated doctor shall report to the commission.]  The report of
15-42    the designated doctor has presumptive weight, and the commission
15-43    shall base its determination of whether the employee has reached
15-44    maximum medical improvement on the report unless the great weight
15-45    of the other medical evidence is to the contrary.
15-46          SECTION 5.04. The Research and Oversight Council on Workers'
15-47    Compensation shall report to the legislature not later than
15-48    December 31, 2002, regarding issues related to medical examinations
15-49    conducted under Section 408.0041, Labor Code, as added by this
15-50    article.
15-51          SECTION 5.05. Section 408.004, Labor Code, as amended by this
15-52    article, applies only to a request for a medical examination made
15-53    to the Texas Workers' Compensation Commission by an insurance
15-54    carrier on or after January 1, 2002.
15-55         ARTICLE 6. MEDICAL BENEFIT REGULATION; DISPUTE RESOLUTION
15-56          SECTION 6.01. Section 408.028, Labor Code, is amended to read
15-57    as follows:
15-58          Sec. 408.028.  PHARMACEUTICAL SERVICES. (a)  A physician
15-59    [health care practitioner] providing care to an employee under this
15-60    subchapter shall prescribe for the employee any necessary
15-61    prescription drugs, and over-the-counter alternatives to
15-62    prescription medications as clinically appropriate and applicable,
15-63    in accordance with applicable state law and as provided by
15-64    Subsection (b).  A doctor providing care may order over-the-counter
15-65    alternatives to prescription medications, when clinically
15-66    appropriate, in accordance with applicable state law and as
15-67    provided by Subsection (b).
15-68          (b)  The commission by rule shall develop an open formulary
15-69    under Section 413.011 that requires the use of generic
 16-1    pharmaceutical medications and clinically appropriate
 16-2    over-the-counter alternatives to prescription medications unless
 16-3    otherwise specified by the prescribing doctor, in accordance with
 16-4    applicable state law.
 16-5          (c)  Except as otherwise provided by this subtitle, an [An]
 16-6    insurance carrier may not require an employee to use pharmaceutical
 16-7    services designated by the carrier.
 16-8          (d)  The commission shall adopt rules to allow an employee to
 16-9    purchase over-the-counter alternatives to prescription medications
16-10    prescribed or ordered under Subsection (a) or (b) and to obtain
16-11    reimbursement from the insurance carrier for those medications.
16-12          SECTION 6.02.  Section 413.011, Labor Code, is amended to
16-13    read as follows:
16-14          Sec. 413.011.  FEE GUIDELINES; TREATMENT GUIDELINES [AND
16-15    MEDICAL POLICIES].  (a)  The commission by rule shall adopt by
16-16    reference the reimbursement methodology and model used by the
16-17    Medicare system with minimal modifications to that reimbursement
16-18    methodology as necessary to meet occupational injury requirements
16-19    and to allow chiropractors to serve as treating doctors.  This
16-20    section may not be interpreted in a manner inconsistent with state
16-21    laws relating to insurance equity regarding parity of payment or
16-22    fee reimbursement levels based on provider type, license,
16-23    discipline, or specialty.  The commission shall calculate
16-24    conversion factors to set fees for services based on that
16-25    methodology and shall provide for reasonable fees for the
16-26    evaluation and management of care by treating doctors as required
16-27    by Section 408.025(c) and commission rules.  The commission shall
16-28    adopt other Medicare requirements and related rules, including
16-29    coding compliance standards, to meet the standards for reporting
16-30    documentation and billing required by Section 413.053, and
16-31    guidelines relating to [establish medical policies and guidelines
16-32    relating to:]
16-33                [(1)  fees charged or paid for medical services for
16-34    employees who suffer compensable injuries, including guidelines
16-35    relating to payment of fees for specific medical treatments or
16-36    services;]
16-37                [(2)  use of medical services by employees who suffer
16-38    compensable injuries; and]
16-39                [(3)]  fees charged or paid for providing expert
16-40    testimony relating to an issue arising under this subtitle.
16-41          (b)  Guidelines for medical services fees must be fair and
16-42    reasonable and designed to ensure the quality of medical care and
16-43    to achieve effective medical cost control.  The guidelines may not
16-44    provide for payment of a fee in excess of the fee charged for
16-45    similar treatment of an injured individual of an equivalent
16-46    standard of living and paid by that individual or by someone acting
16-47    on that individual's behalf.  The commission shall consider the
16-48    increased security of payment afforded by this subtitle in
16-49    establishing the fee guidelines.
16-50          (c)  The commission by rule may adopt treatment guidelines.
16-51    If adopted, treatment guidelines adopted must be nationally
16-52    recognized, scientifically valid, and outcome-based and designed to
16-53    reduce excessive or inappropriate medical care while safeguarding
16-54    necessary medical care [Medical policies adopted by the commission
16-55    must be consistent with Sections 413.013, 413.020, 413.052, and
16-56    413.053].
16-57          (d)  The commission by rule may [shall] establish medical
16-58    policies relating to necessary treatments for injuries.
16-59          (e)  Any medical [Medical] policies or guidelines adopted by
16-60    the commission must [shall] be:
16-61                (1)  designed to ensure the quality of medical care and
16-62    to achieve effective medical cost control;
16-63                (2)  designed to enhance a timely and appropriate
16-64    return to work; and
16-65                (3)  consistent with Sections 413.013, 413.020,
16-66    413.052, and 413.053.
16-67          SECTION 6.03. Section 413.031, Labor Code, is amended to read
16-68    as follows:
16-69          Sec. 413.031.  MEDICAL DISPUTE RESOLUTION. (a)  A party,
 17-1    including a health care provider or claimant, is entitled to a
 17-2    review of a medical service provided or for which authorization of
 17-3    payment is sought if that party [a health care provider] is:
 17-4                (1)  denied payment or paid a reduced amount for the
 17-5    medical service rendered;
 17-6                (2)  denied authorization for the payment for the
 17-7    service requested or performed if authorization is required or
 17-8    allowed by this subtitle or [the medical policies of the]
 17-9    commission rules; [or]
17-10                (3)  ordered by the commission [division] to refund a
17-11    payment received; or
17-12                (4)  ordered to make a payment that was refused or
17-13    reduced for a medical service rendered.
17-14          (b)  A health care provider who submits a charge in excess of
17-15    the fee guidelines or treatment policies is entitled to a review of
17-16    the medical service to determine if reasonable medical
17-17    justification exists for the deviation.
17-18          (c)  In resolving disputes over the amount of payment due for
17-19    services determined to be medically necessary and appropriate for
17-20    treatment of a compensable injury, the role of the commission is to
17-21    adjudicate the correct payment given the relevant statutory
17-22    provisions and commission rules.  The commission shall publish on
17-23    its Internet website its medical dispute decisions, including
17-24    decisions of independent review organizations, and any subsequent
17-25    decisions by the State Office of Administrative Hearings.  Before
17-26    publication, the commission shall redact only that information
17-27    necessary to prevent identification of the injured worker.
17-28          (d)  A review of the medical necessity of a health care
17-29    [medical] service requiring preauthorization under Section 413.014
17-30    or commission rules under that [this] section shall be conducted by
17-31    an independent review organization under Article 21.58C, Insurance
17-32    Code, in the same manner as reviews of utilization review decisions
17-33    by health maintenance organizations.  It is a defense for the
17-34    insurance carrier if the carrier timely complies with the decision
17-35    of the independent review organization.  The commission by rule
17-36    shall specify the appropriate dispute resolution process for
17-37    disputes in which a claimant has paid for medical services and is
17-38    seeking reimbursement [provided by a health care provider
17-39    professional review organization if requested by the health care
17-40    practitioner or if ordered by the commission].
17-41          (e)  Except as provided by Subsection (d), a review of the
17-42    medical necessity of a health care service provided under this
17-43    chapter or Chapter 408 shall be conducted by an independent review
17-44    organization under Article 21.58C, Insurance Code, in the same
17-45    manner as reviews of utilization review decisions by health
17-46    maintenance organizations. It is a defense for the insurance
17-47    carrier if the carrier timely complies with the decision of the
17-48    independent review organization.
17-49          (f)  The insurance carrier shall pay the cost of the review
17-50    if the dispute arises in connection with a request for health care
17-51    services that require preauthorization under Section 413.014 or
17-52    commission rules under that section.
17-53          (g)  Except as provided by Subsection (f), the cost of the
17-54    review shall be paid by the nonprevailing party.
17-55          (h)  Notwithstanding Subsections (f) and (g), an employee may
17-56    not be required to pay any portion of the cost of a review.
17-57          (i) [(d)]  A party to a medical dispute that remains
17-58    unresolved after a review of the medical service under this section
17-59    is entitled to a hearing.  The hearing shall be conducted by the
17-60    State Office of Administrative Hearings within 90 days of receipt
17-61    of a request for a hearing in the manner provided for a contested
17-62    case under Chapter 2001, Government Code (the administrative
17-63    procedure law).
17-64          SECTION 6.04. Section 413.041, Labor Code, is amended to read
17-65    as follows:
17-66          Sec. 413.041.  DISCLOSURE. (a)  Each doctor shall disclose to
17-67    the commission the identity of any health care provider in which
17-68    the doctor, or the health care provider that employs the doctor,
17-69    has a financial interest.  The doctor shall make the disclosure in
 18-1    the manner provided by commission rule.
 18-2          (b)  The commission shall require by rule that a doctor
 18-3    disclose financial interests in other health care providers as a
 18-4    condition of registration for the approved doctor list established
 18-5    under Section 408.023, and shall define "financial interest" for
 18-6    purposes of this subsection as provided by analogous federal
 18-7    regulations.  The commission by rule shall adopt the federal
 18-8    standards that prohibit the payment or acceptance of payment in
 18-9    exchange for health care referrals.
18-10          (c)  A doctor or health care provider that fails to comply
18-11    with this section is subject to penalties and sanctions as provided
18-12    by this subtitle, including forfeiture of the right to
18-13    reimbursement for services rendered during the period of
18-14    noncompliance.
18-15          (d)  The commission shall publish all final disclosure
18-16    enforcement orders issued under this section on the commission's
18-17    Internet website [A health care provider who refers a workers'
18-18    compensation claimant to another health care provider in which the
18-19    referring provider has more than a five percent financial interest
18-20    shall file an annual disclosure statement with the commission as
18-21    provided by commission rules and shall disclose the interest to the
18-22    insurance carrier at the time of the referral.  The referring
18-23    provider shall specify the degree of the financial interest and
18-24    shall provide other information as required by commission rules].
18-25          SECTION 6.05. Section 415.0035, Labor Code, is amended by
18-26    adding Subsections (e) and (f) to read as follows:
18-27          (e)  An insurance carrier or health care provider commits an
18-28    administrative violation if that person violates this subtitle or a
18-29    rule, order, or decision of the commission.
18-30          (f)  A subsequent administrative violation under this
18-31    section, after prior notice to the insurance carrier or health care
18-32    provider of noncompliance, is subject to penalties as provided by
18-33    Section 415.021. Prior notice under this subsection is not required
18-34    if the violation was committed wilfully or intentionally, or if the
18-35    violation was of a decision or order of the commission.
18-36          SECTION 6.06. Section 415.021(a), Labor Code, is amended to
18-37    read as follows:
18-38          (a)  The commission may assess an administrative penalty
18-39    against a person who commits an administrative violation.
18-40    Notwithstanding Subsection (c), the commission by rule shall adopt
18-41    a schedule of specific monetary administrative penalties for
18-42    specific violations under this subtitle.
18-43          SECTION 6.07. Section 415.023, Labor Code, is amended to read
18-44    as follows:
18-45          Sec. 415.023.  COMMISSION OF WRONGFUL ACT AS MATTER OF
18-46    PRACTICE; ADMINISTRATIVE VIOLATION. (a)  A person who commits an
18-47    administrative violation under Section 415.001, 415.002, [or]
18-48    415.003, or 415.0035 as a matter of practice is subject to an
18-49    applicable rule adopted under Subsection (b) in addition to the
18-50    penalty assessed for the violation.
18-51          (b)  The commission may adopt rules providing for:
18-52                (1)  a reduction or denial of fees;
18-53                (2)  public or private reprimand by the commission;
18-54                (3)  suspension from practice before the commission;
18-55    [or]
18-56                (4)  restriction, suspension, or revocation of the
18-57    right to receive reimbursement under this subtitle; or
18-58                (5)  referral and petition to the appropriate licensing
18-59    authority for appropriate disciplinary action, including the
18-60    restriction, suspension, or revocation of the person's license.
18-61          SECTION 6.08. (a)  The Texas Workers' Compensation Commission
18-62    shall adopt the rules and fee guidelines under Section 413.011,
18-63    Labor Code, as amended by this article, not later than May 1, 2002.
18-64    Unless subsequently readopted by the commission, the treatment
18-65    guidelines adopted under Chapter 413, Labor Code, in effect
18-66    immediately before September 1, 2001, are not applicable to health
18-67    care services provided on or after January 1, 2002.
18-68          (b)  The Texas Workers' Compensation Commission shall adopt
18-69    rules as required by Sections 408.028 and 413.041, Labor Code, as
 19-1    amended by this article, not later than June 1, 2002.
 19-2          (c)  The change in law made by this article by the amendment
 19-3    of Section 413.031, Labor Code, applies only to a request for a
 19-4    review of medical services received on or after January 1, 2002.  A
 19-5    request received before that date is covered by the law in effect
 19-6    immediately before September 1, 2001, and that law is continued in
 19-7    effect for that purpose.
 19-8          (d)  Section 413.041(c), Labor Code, as added by this
 19-9    article, applies only to a failure to comply with Section 413.041
19-10    that occurs after June 1, 2002.
19-11          (e)  Section 415.0035, Labor Code, as amended by this
19-12    article, applies only to a violation occurring on or after
19-13    September 1, 2002.
19-14                     ARTICLE 7.  SUNSET REVIEW; AUDIT
19-15          SECTION 7.01.  Section 401.002, Labor Code, is amended to
19-16    read as follows:
19-17          Sec. 401.002.  APPLICATION OF SUNSET ACT. The Texas Workers'
19-18    Compensation Commission is subject to Chapter 325, Government Code
19-19    (Texas Sunset Act).  Unless continued in existence as provided by
19-20    that chapter, the commission is abolished September 1, 2005 [2007].
19-21          SECTION 7.02.  Subchapter A, Chapter 401, Labor Code, is
19-22    amended by adding Section 401.003 to read as follows:
19-23          Sec. 401.003.  ACTIVITIES OF THE STATE AUDITOR. (a)  The
19-24    commission is subject to audit by the state auditor in accordance
19-25    with Chapter 321, Government Code.  The state auditor may audit the
19-26    commission's:
19-27                (1)  structure and internal controls;
19-28                (2)  level and quality of service provided to
19-29    employers, injured employees, insurance carriers, self-insured
19-30    governmental entities, and other participants;
19-31                (3)  implementation of statutory mandates;
19-32                (4)  employee turnover;
19-33                (5)  information management systems, including public
19-34    access to nonconfidential information;
19-35                (6)  adoption and implementation of administrative
19-36    rules; and
19-37                (7)  assessment of administrative violations and the
19-38    penalties for those violations.
19-39          (b)  Nothing in this section limits the authority of the
19-40    state auditor under Chapter 321, Government Code.
19-41                        ARTICLE 8.  ATTORNEY'S FEES
19-42          SECTION 8.01. Section 408.221, Labor Code, is amended to read
19-43    as follows:
19-44          Sec. 408.221.  ATTORNEY'S FEES PAID TO CLAIMANT'S COUNSEL.
19-45    (a)  An attorney's fee, including a contingency fee, for
19-46    representing a claimant before the commission or court under this
19-47    subtitle must be approved by the commission or court.
19-48          (b)  Except as otherwise provided, an attorney's fee under
19-49    this section is based on the attorney's time and expenses according
19-50    to written evidence presented to the commission or court. Except as
19-51    provided by Subsection (c) or Section 408.147(c), the attorney's
19-52    fee shall be paid from the claimant's recovery.
19-53          (c)  An insurance carrier that seeks judicial review under
19-54    Subchapter G, Chapter 410, of a final decision of a commission
19-55    appeals panel regarding compensability or eligibility for, or the
19-56    amount of, income or death benefits is liable for reasonable and
19-57    necessary attorney's fees incurred by the claimant as a result of
19-58    the insurance carrier's appeal if the claimant prevails on an issue
19-59    on which judicial review is sought by the insurance carrier in
19-60    accordance with the limitation of issues contained in Section
19-61    410.302.  This subsection does not apply to attorney's fees for
19-62    which an insurance carrier may be liable under Section 408.147.  An
19-63    award of attorney's fees under this subsection is not subject to
19-64    commission rules adopted under Subsection (f).  This subsection
19-65    expires September 1, 2005.
19-66          (d)  In approving an attorney's fee under this section, the
19-67    commission or court shall consider:
19-68                (1)  the time and labor required;
19-69                (2)  the novelty and difficulty of the questions
 20-1    involved;
 20-2                (3)  the skill required to perform the legal services
 20-3    properly;
 20-4                (4)  the fee customarily charged in the locality for
 20-5    similar legal services;
 20-6                (5)  the amount involved in the controversy;
 20-7                (6)  the benefits to the claimant that the attorney is
 20-8    responsible for securing; and
 20-9                (7)  the experience and ability of the attorney
20-10    performing the services.
20-11          (e) [(d)]  The commission by rule or the court may provide
20-12    for the commutation of an attorney's fee, except that the
20-13    attorney's fee shall be paid in periodic payments in a claim
20-14    involving death benefits if the only dispute is as to the proper
20-15    beneficiary or beneficiaries.
20-16          (f) [(e)]  The commission by rule shall provide guidelines
20-17    for maximum attorney's fees for specific services in accordance
20-18    with this section.
20-19          (g) [(f)]  An attorney's fee may not be allowed in a case
20-20    involving a fatal injury or lifetime income benefit if the
20-21    insurance carrier admits liability on all issues and tenders
20-22    payment of maximum benefits in writing under this subtitle while
20-23    the claim is pending before the commission.
20-24          (h) [(g)]  An attorney's fee shall be paid to the attorney by
20-25    separate draft.
20-26          (i) [(h)]  Except as provided by Subsection (c) or Section
20-27    408.147(c), an attorney's fee may not exceed 25 percent of the
20-28    claimant's recovery.
20-29          SECTION 8.02. Section 408.147(c), Labor Code, is amended to
20-30    read as follows:
20-31          (c)  If an insurance carrier disputes a commission
20-32    determination that an employee is entitled to supplemental income
20-33    benefits or the amount of supplemental income benefits due and the
20-34    employee prevails on any disputed issue, the insurance carrier is
20-35    liable for reasonable and necessary attorney's fees incurred by the
20-36    employee as a result of the insurance carrier's dispute and for
20-37    supplemental income benefits accrued but not paid and interest on
20-38    that amount, according to Section 408.064.  Attorney's fees awarded
20-39    under this subsection are not subject to Sections 408.221(b), (f)
20-40    [(e)], and (i) [(h)].
20-41          SECTION 8.03. Section 408.222(b), Labor Code, is amended to
20-42    read as follows:
20-43          (b)  In determining whether a fee is reasonable under this
20-44    section, the commission or court shall consider issues analogous to
20-45    those listed under Section 408.221(d) [408.221(c)].  The defense
20-46    counsel shall present written evidence to the commission or court
20-47    relating to:
20-48                (1)  the time spent and expenses incurred in defending
20-49    the case; and
20-50                (2)  other evidence considered necessary by the
20-51    commission or court in making a determination under this section.
20-52                   ARTICLE 9.  LIFETIME INCOME BENEFITS
20-53          SECTION 9.01.  Section 408.161(a), Labor Code, is amended to
20-54    read as follows:
20-55          (a)  Lifetime income benefits are paid until the death of the
20-56    employee for:
20-57                (1)  total and permanent loss of sight in both eyes;
20-58                (2)  loss of both feet at or above the ankle;
20-59                (3)  loss of both hands at or above the wrist;
20-60                (4)  loss of one foot at or above the ankle and the
20-61    loss of one hand at or above the wrist;
20-62                (5)  an injury to the spine that results in permanent
20-63    and complete paralysis of both arms, both legs, or one arm and one
20-64    leg; [or]
20-65                (6)  a physically traumatic injury to the brain
20-66    resulting in incurable insanity or imbecility; or
20-67                (7)  burns that result in at least 40 percent of the
20-68    body being subject to debriding or grafting, or third degree burns
20-69    covering the majority of either both hands or one hand and the
 21-1    head.
 21-2         ARTICLE 10.  MULTIPLE EMPLOYMENT; SUBSEQUENT INJURY FUND
 21-3          SECTION 10.01. Section 403.006, Labor Code, is amended by
 21-4    amending Subsection (b) and adding Subsection (d) to read as
 21-5    follows:
 21-6          (b)  The subsequent injury fund is liable for:
 21-7                (1)  the payment of compensation as provided by Section
 21-8    408.162;
 21-9                (2)  reimbursement of insurance carrier claims of
21-10    overpayment of benefits based on interlocutory orders of the
21-11    commission as provided by this subtitle, consistent with the
21-12    priorities established by rule by the commission;
21-13                (3)  reimbursement of insurance carrier claims as
21-14    provided by Sections 408.042 and 413.0141, consistent with the
21-15    priorities established by rule by the commission; and
21-16                (4)  the payment of an assessment of feasibility and
21-17    the development of regional networks established under Section
21-18    408.0221.
21-19          (d)  Based on an actuarial assessment of the funding
21-20    available under Section 403.007(e), the commission may make partial
21-21    payment of insurance carrier claims under Subsection (b)(3).
21-22          SECTION 10.02. Section 403.007, Labor Code, is amended by
21-23    adding Subsections (e) and (f) to read as follows:
21-24          (e)  If the commission determines that the funding under
21-25    Subsection (a) is not adequate to meet the expected obligations of
21-26    the subsequent injury fund established under Section 403.006, the
21-27    fund shall be supplemented by the collection of a maintenance tax
21-28    paid by insurance carriers, other than a governmental entity, as
21-29    provided by Sections 403.002 and 403.003.  The rate of assessment
21-30    must be adequate to provide 120 percent of the projected unfunded
21-31    liabilities of the fund for the next biennium as certified by an
21-32    independent actuary or financial advisor.
21-33          (f)  The commission's actuary or financial advisor shall
21-34    report biannually to the Research and Oversight Council on Workers'
21-35    Compensation on the financial condition and projected assets and
21-36    liabilities of the subsequent injury fund.  The commission shall
21-37    make the reports available to members of the legislature and the
21-38    public.  The commission may purchase annuities to provide for
21-39    payments due to claimants under this subtitle if the commission
21-40    determines that the purchase of annuities is financially prudent
21-41    for the administration of the fund.
21-42          SECTION 10.03. Section 408.042, Labor Code, is amended to
21-43    read as follows:
21-44          Sec. 408.042.  AVERAGE WEEKLY WAGE FOR PART-TIME EMPLOYEE OR
21-45    EMPLOYEE WITH MULTIPLE EMPLOYMENT. (a)  The average weekly wage of
21-46    a part-time employee who limits the employee's work to less than
21-47    [full-time hours or] a full-time workweek as a regular course of
21-48    that employee's conduct is computed as provided by Section 408.041.
21-49          (b)  For part-time employees not covered by Subsection (a),
21-50    the average weekly wage:
21-51                (1)  for determining temporary income benefits is
21-52    computed as provided by Section 408.041; and
21-53                (2)  for determining impairment income benefits,
21-54    supplemental income benefits, lifetime income benefits, and death
21-55    benefits is computed as follows:
21-56                      (A)  if the employee has worked for the employer
21-57    for at least the 13 weeks immediately preceding the date of the
21-58    injury, the average weekly wage is computed by dividing the sum of
21-59    the wages paid in the 13 consecutive weeks immediately preceding
21-60    the date of the injury by 13 and adjusting that amount to the
21-61    weekly wage level the employee would have attained by working a
21-62    full-time workweek at the same rate of pay; or
21-63                      (B)  if the employee has worked for the employer
21-64    for less than 13 weeks immediately preceding the date of the
21-65    injury, the average weekly wage is equal to:
21-66                            (i)  the weekly wage that the employer pays
21-67    a similar employee for similar services based on a [in] full-time
21-68    workweek [employment]; or
21-69                            (ii)  if a similar employee does not exist,
 22-1    the usual wage paid in that vicinity for the same or similar
 22-2    services based on a [provided for compensation in] full-time
 22-3    workweek [employment].
 22-4          (c)  For employees with multiple employment, the average
 22-5    weekly wage for determining temporary income benefits, impairment
 22-6    income benefits, supplemental income benefits, lifetime income
 22-7    benefits, and death benefits, is computed as follows:
 22-8                (1)  the average weekly wage for an employee with
 22-9    multiple employment is equal to the sum of the average weekly wages
22-10    computed under Subdivisions (2) and (3);
22-11                (2)  for each of the employers for whom the employee
22-12    has worked for at least the 13 weeks immediately preceding the date
22-13    of injury, the average weekly wage is equal to the sum of the wages
22-14    paid by that employer to the employee in the 13 weeks immediately
22-15    preceding the injury divided by 13;
22-16                (3)  for each of the employers for whom the employee
22-17    has worked for less than the 13 weeks immediately preceding the
22-18    date of the injury, the average weekly wage is equal to:
22-19                      (A)  the weekly wage that employer pays similar
22-20    employees for similar services; or
22-21                      (B)  if a similar employee does not exist, the
22-22    usual weekly wage paid in that vicinity for the same or similar
22-23    services; and
22-24                (4)  the average weekly wage of an employee with
22-25    multiple employment who limits the employee's work to less than a
22-26    full-time workweek, but does not do so as a regular course of that
22-27    employee's conduct, is adjusted to the weekly wage level the
22-28    employee would have attained by working a full-time workweek at the
22-29    employee's average rate of pay.
22-30          (d)  The commission shall:
22-31                (1)  prescribe a form to collect information regarding
22-32    the wages of employees with multiple employment; and
22-33                (2)  by rule, determine the manner by which wage
22-34    information is collected and distributed to implement this section.
22-35          (e)  For an employee with multiple employment, only the
22-36    employee's wages that are reportable for federal income tax
22-37    purposes may be considered.  The employee shall document and verify
22-38    wage payments subject to this section.
22-39          (f)  If the commission determines that computing the average
22-40    weekly wage for an employee as provided by Subsection (c) is
22-41    impractical or unreasonable, the commission shall set the average
22-42    weekly wage in a manner that more fairly reflects the employee's
22-43    average weekly wage and that is fair and just to both parties or is
22-44    in the manner agreed to by the parties.  The commission by rule may
22-45    define methods to determine a fair and just average weekly wage
22-46    consistent with this section.
22-47          (g)  An insurance carrier is entitled to apply for and
22-48    receive reimbursement at least annually from the subsequent injury
22-49    fund for the amount of income benefits paid to a worker under this
22-50    section that are based on employment other than the employment
22-51    during which the compensable injury occurred.  The commission may
22-52    adopt rules that govern the documentation, application process, and
22-53    other administrative requirements necessary to implement this
22-54    subsection.
22-55          (h)  In this section:
22-56                (1)  "Employee with multiple employment" means an
22-57    employee who has more than one employer.
22-58                (2)  "Full-time workweek" means a 40-hour workweek.
22-59                (3)  "Part-time[, "part-time] employee" means an
22-60    employee who, at the time of the injury, was working less than a
22-61    [the] full-time [hours or full-time] workweek for the employer for
22-62    whom the employee was working when the compensable injury occurred
22-63    [of similar employees in the same employment, whether for the same
22-64    or a different employer].
22-65                ARTICLE 11.  INSURANCE CARRIER INFORMATION
22-66          SECTION 11.01. Section 410.164, Labor Code, is amended by
22-67    adding Subsection (c) to read as follows:
22-68          (c)  At each contested case hearing, as applicable, the
22-69    insurance carrier shall file with the hearing officer and shall
 23-1    deliver to the claimant a single document stating the true
 23-2    corporate name of the insurance carrier and the name and address of
 23-3    the insurance carrier's registered agent for service of process.
 23-4    The document is part of the record of the contested case hearing.
 23-5          SECTION 11.02. Section 410.204, Labor Code, is amended by
 23-6    adding Subsection (d) to read as follows:
 23-7          (d)  Each final decision of the appeals panel shall conclude
 23-8    with a separate paragraph stating: "The true corporate name of the
 23-9    insurance carrier is (NAME IN BOLD PRINT) and the name and address
23-10    of its registered agent for service of process is (NAME AND ADDRESS
23-11    IN BOLD PRINT)."
23-12          SECTION 11.03. This article applies only to a workers'
23-13    compensation hearing that is conducted on or after the effective
23-14    date of this Act.  A hearing that is conducted before that date is
23-15    governed by the law in effect on the date the hearing was
23-16    conducted, and the former law is continued in effect for that
23-17    purpose.
23-18                     ARTICLE 12.  APPEAL REQUIREMENTS
23-19          SECTION 12.01. Section 410.202, Labor Code, is amended by
23-20    adding Subsection (d) to read as follows:
23-21          (d)  Saturdays and Sundays and holidays listed in Section
23-22    662.003, Government Code, are not included in the computation of
23-23    the time in which a request for an appeal under Subsection (a) or a
23-24    response under Subsection (b) must be filed.
23-25          SECTION 12.02. The change in law made by this article applies
23-26    only to an appeal in a workers' compensation proceeding filed on or
23-27    after the effective date of this Act.  An appeal filed before the
23-28    effective date of this Act is governed by the law in effect on the
23-29    date the appeal was filed, and the former law is continued in
23-30    effect for that purpose.
23-31          ARTICLE 13.  STUDY ON DRUG-FREE WORKPLACE REQUIREMENTS
23-32          SECTION 13.01. Subchapter G, Chapter 411, Labor Code, is
23-33    amended by adding Section 411.093 to read as follows:
23-34          Sec. 411.093.  STUDY ON DRUG-FREE WORKPLACE; REPORT. (a)  The
23-35    commission shall study:
23-36                (1)  the implementation and development of drug-free
23-37    workplace policies under this subchapter;
23-38                (2)  the use of drug-free workplace requirements
23-39    adopted by other jurisdictions to reduce the adverse impact on the
23-40    operation of workers' compensation insurance systems of drug abuse
23-41    and its effects in the workplace; and
23-42                (3)  any other aspects of the effect of drug abuse on
23-43    the operation of the workers' compensation insurance system in this
23-44    state as considered appropriate by the commission or the Research
23-45    and Oversight Council on Workers' Compensation.
23-46          (b)  The commission shall report not later than  February 1,
23-47    2003, to the legislature and the Research and Oversight Council on
23-48    Workers' Compensation regarding the study conducted under this
23-49    section. The report must include:
23-50                (1)  any commission recommendations for legislative
23-51    changes in the workers' compensation laws as regards the
23-52    implementation of a drug-free workplace requirement; and
23-53                (2)  an analysis of the possible effects of the
23-54    adoption of a workers' compensation insurance premium discount
23-55    program for employers who maintain a drug-free workplace on the
23-56    operation of the workers' compensation insurance system in this
23-57    state.
23-58          (c)  On the request of the commission, the Texas Department
23-59    of Insurance shall assist the commission in the performance of its
23-60    duties under this section.
23-61          (d)  This section expires September 1, 2003.
23-62              ARTICLE 14.  GENERAL TRANSITION; EFFECTIVE DATE
23-63          SECTION 14.01. Except as otherwise provided by this Act, this
23-64    Act applies only to a claim for workers' compensation benefits
23-65    based on a compensable injury that occurs on or after the effective
23-66    date of this Act.  A claim based on a compensable injury that
23-67    occurs before that date is governed by the law in effect on the
23-68    date that the compensable injury occurred, and the former law is
23-69    continued in effect for that purpose.
 24-1          SECTION 14.02. Except as expressly provided, this Act takes
 24-2    effect September 1, 2001.
 24-3                                 * * * * *