LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 77th Regular Session
March 23, 2001
TO: Honorable Kim Brimer, Chair, House Committee on Business
& Industry
FROM: John Keel, Director, Legislative Budget Board
IN RE: HB1202 by Brimer (Relating to the medical review of
health care provided under the workers' compensation
insurance system.), Committee Report 1st House,
Substituted
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* Estimated Two-year Net Impact to General Revenue Related Funds for *
* HB1202, Committee Report 1st House, Substituted: positive impact *
* of $0 through the biennium ending August 31, 2003. *
* *
* The bill would make no appropriation but could provide the legal *
* basis for an appropriation of funds to implement the provisions of *
* the bill. *
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General Revenue-Related Funds, Five-Year Impact:
****************************************************
* Fiscal Year Probable Net Positive/(Negative) *
* Impact to General Revenue Related *
* Funds *
* 2002 $0 *
* 2003 0 *
* 2004 0 *
* 2005 0 *
* 2006 0 *
****************************************************
All Funds, Five-Year Impact:
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*Fiscal Probable Probable Revenue Change in Number of *
* Year Savings/(Cost) from Gain/(Loss) from State Employees from *
* General Revenue Fund General Revenue Fund FY 2001 *
* 0001 0001 *
* 2002 $(416,929) $416,929 0.4 *
* 2003 (769,529) 769,529 0.4 *
* 2004 (769,529) 769,529 0.4 *
* 2005 (769,529) 769,529 0.4 *
* 2006 (769,529) 769,529 0.4 *
**************************************************************************
Technology Impact
The Texas Workers' Compensation Commission, the Texas Board of Medical
Examiners, the Texas Board of Podiatric Medical Examiners, and the Texas
Board of Chiropractic Examiners would need to make minor modifications
to databases to collect and maintain doctor status on the Approved
Doctor List.
Fiscal Analysis
The bill would amend Section 408.023 of the Labor Code by changing the
way Texas Workers' Compensation Commission (TWCC) creates and maintains
the Approved Doctors List (ADL) for treatment of workers' compensation
claimants. The bill would require TWCC to register and provide
certificates to doctors included on the ADL by March 2002. The bill would
require TWCC to adopt rules and criteria for doctors receiving
certification in four different categories: treating doctor, designated
doctor, peer review doctor, and utilization review doctor. The bill
would also authorize TWCC to impose sanctions on doctors, including
removal from the ADL.
The bill would also create a full-time position for Medical Advisor and a
Medical Quality Review Panel. The Medical Advisor would be responsible
for setting standards and guidelines, reviewing compliance, and
recommending doctors for deletion from the ADL. The Medical Quality
Review Panel would assist the Medical Advisor in making recommendations
of doctors to be deleted from the ADL, as well as doctors to be added or
suspended from the list.
The bill would take effect September 1, 2001.
Methodology
TWCC estimates a one-time cost of $25,000 for mail notification to all
85,000 doctors in Texas for notification of the change in law. The
agency estimates twelve quality of care doctor audits each year at a cost
of $12,000 per audit. Also, the agency estimates increased disputes from
doctors challenging audit findings and modifications to a doctor's
status on the ADL. These disputes are estimated to cost $47,200 each,
including expert testimony, peer medical review of files, charges at the
State Office of Administrative Hearings, and deposition costs. It is
estimated approximately five disputes would be brought in the first year,
and thirteen each year thereafter. The Medical Advisor position already
exists on a part-time basis, and the bill would require that position to
be increased to a full-time position.
It is assumed TWCC would be adjust the Workers' Compensation Maintenance
Tax rate to offset any costs associated with the implementation of the
bill
Local Government Impact
No fiscal implication to units of local government is anticipated.
Source Agencies: 503 Texas State Board of Medical Examiners, 453
Texas Workers' Compensation Commission, 478
Research and Oversight Council on Workers'
Compensation, 508 Texas Board of Chiropractic
Examiners, 512 Texas State Board of Podiatric
Medical Examiners
LBB Staff: JK, JO, RT, KM