SRC-JEC S.B. 1804 78(R)   BILL ANALYSIS


Senate Research Center   S.B. 1804
By: Harris
State Affairs
4/22/2003
As Filed


DIGEST AND PURPOSE 

Under current law, a person receiving workers' compensation supplemental
income benefits must prove, every three months, that the benefits are
still needed.  As proposed, S.B. 1804 expands the process to a six-month
re-evaluation; the bill also addresses the issue of an insurance carrier
preauthorizing, and later disputing, care.  Additionally, S.B. 1804
requires a study to propose an alternative workers' compensation dispute
resolution process that is less expensive than the current one. 

RULEMAKING AUTHORITY

This bill does not expressly grant any additional rulemaking authority to
a state officer, institution, or agency. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Section 408.143(b), Labor Code, to require that the
statement required under this section, unless modified by the Texas
Workers' Compensation Commission (TWCC), be filed quarterly until the
first anniversary of the date of TWCC's initial determination of
supplemental benefits and, after that date, every six months.  Makes a
conforming change. 

SECTION 2.  Amends Section 408.151(b), Labor Code, to require that the
examination, in addition to determining whether the employee's medical
condition has improved, include a determination of the type of employment
the employee is physically or medically able to perform. 

SECTION 3.  Amends Subchapter C, Chapter 413, Labor Code, by adding
Section 413.032, as follows: 

Sec. 413.032.  ALTERNATIVE MEDICAL DISPUTE RESOLUTION PROCESS.  (a)
Requires TWCC to evaluate the effectiveness and costs of the medical
dispute resolution process under Section 413.031 and study proposals for
the establishment of an alternative process.  Requires TWCC, in performing
the study and proposing the alternative process, to emphasize the
establishment of a process that is less expensive than the current system. 

(b)  Requires TWCC, in performing its duties under this section, to
solicit the participation of persons who represent the interests of
employees, employers, health care providers, insurance carriers,
governmental agencies, and others who may be interested in the results of
the study. 

(c)  Requires TWCC to report the results of the study, including TWCC's
proposal, to the lieutenant governor and speaker of the house of
representatives not later than December 1, 2004. 

(d)  Provides that this section expires January 1, 2006.

 SECTION  4.  Amends Section 413.014(e), Labor Code, to prohibit TWCC from
prohibiting an insurance carrier and a health care provider from
voluntarily discussing pharmaceutical services, either prospectively or
concurrently.  Provides that the insurance carrier is liable for health
care treatment and treatment plans and pharmaceutical services that are
voluntarily preauthorized and prohibits the insurance carrier from
disputing the certified or agreed-upon preauthorized health care treatment
and treatment plans and pharmaceutical services at a later date. 

SECTION  5.  (a)  Effective date:  September 1, 2003.

  (b)  Makes application of this Act prospective.