By Van de Putte S.B. No. 942
77R7563 PB-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to insurance carrier reimbursement regarding benefit
1-3 overpayments on certain workers' compensation claims.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Section 410.209, Labor Code, is amended to read as
1-6 follows:
1-7 Sec. 410.209. REIMBURSEMENT FOR OVERPAYMENT. (a) The
1-8 subsequent injury fund shall reimburse an insurance carrier for any
1-9 overpayments of benefits made under an interlocutory order or
1-10 decision if that order or decision is reversed or modified by final
1-11 arbitration, order, or decision of the commission or a court.
1-12 (b) An insurance carrier that receives reimbursement under
1-13 Subsection (a) does not have a cause of action against the injured
1-14 employee for any further recovery regarding the overpayment.
1-15 (c) The commission shall adopt rules as necessary to
1-16 implement this section, including rules to provide for a periodic
1-17 reimbursement schedule, providing for reimbursement at least
1-18 annually.
1-19 SECTION 2. Section 413.055, Labor Code, is amended to read as
1-20 follows:
1-21 Sec. 413.055. INTERLOCUTORY ORDERS; REIMBURSEMENT. (a) The
1-22 executive director, as provided by commission rule, may enter an
1-23 interlocutory order for the payment of all or part of medical
1-24 benefits. The order may address accrued benefits, future benefits,
2-1 or both accrued benefits and future benefits. A party that
2-2 disputes an order entered under this subsection is entitled to a
2-3 hearing conducted by the State Office of Administrative Hearings in
2-4 the manner provided for a contested case under Chapter 2001,
2-5 Government Code. The order is binding during the pendency of the
2-6 appeal.
2-7 (b) The subsequent injury fund shall reimburse an insurance
2-8 carrier for any overpayments of benefits made under an order
2-9 entered under Subsection (a) if the order is reversed or modified
2-10 by final arbitration, order, or decision of the commission or a
2-11 court. The commission shall adopt rules to provide for a periodic
2-12 reimbursement schedule, providing for reimbursement at least
2-13 annually.
2-14 (c) An insurance carrier that receives reimbursement under
2-15 Subsection (b) does not have a cause of action against the injured
2-16 employee for any further recovery regarding the overpayment. [A
2-17 party that disputes an order entered under Subsection (a) is
2-18 entitled to a hearing. The hearing shall be conducted by the State
2-19 Office of Administrative Hearings in the manner provided for a
2-20 contested case under Chapter 2001, Government Code. The order is
2-21 binding during the pendency of the appeal.]
2-22 SECTION 3. This Act takes effect September 1, 2001, and
2-23 applies only to a claim for workers' compensation benefits based on
2-24 a compensable injury that occurs on or after that date. A claim
2-25 based on a compensable injury that occurs before that date is
2-26 governed by the law in effect on the date that the compensable
2-27 injury occurred, and the former law is continued in effect for that
3-1 purpose.