78R2779 KSD-F

By:  Berman                                                       H.B. No. 566



A BILL TO BE ENTITLED

AN ACT

relating to the pursuit of a private claim against a workers' 
compensation claimant by a health care provider.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:                        
	SECTION 1.  Section 413.042, Labor Code, is amended by 
amending Subsection (a) and adding Subsections (c)-(f) to read as 
follows:
	(a)  A health care provider may not pursue a private claim 
against a workers' compensation claimant for all or part of the cost 
of a health care service provided to the claimant by the provider 
unless:
		(1)  except as provided by Subsection (c), the injury 
is finally adjudicated not compensable under this subtitle; or
		(2)  the employee violates Section 408.022 relating to 
the selection of a doctor and the doctor did not know of the 
violation at the time the services were rendered.
	(c)  A health care provider may pursue a private claim 
against an injured employee or the employee's insurance carrier for 
all or part of the cost of a health care service provided to the 
employee by the provider if the employee does not contest the denial 
of benefits by the insurance carrier under Chapter 410 within 45 
days after the date the employee received notice from the insurance 
carrier of the insurance carrier's refusal to pay benefits.
	(d)  If a health care provider pursues a private claim 
against an injured employee or the employee's insurance carrier 
under Subsection (c) and the employee subsequently contests the 
denial of benefits by the insurance carrier under Chapter 410, the 
employee must provide immediate written notice to the provider 
regarding the employee's pursuit of a claim under Chapter 410.
	(e)  On receipt of written notice under Subsection (d), the 
health care provider shall stop the active pursuit of the 
provider's private claim until the employee's injury is finally 
adjudicated not compensable under this subtitle.  The provider is 
entitled to become a party to the employee's claim under Chapter 410 
and to receive information from the commission and the employee 
regarding the adjudication of the employee's claim.
	(f)  A health care provider who, after receiving written 
notice from an injured employee under Subsection (d), continues to 
actively pursue the provider's private claim against the employee 
before the employee's injury is finally adjudicated may not recover 
any portion of any benefits awarded to the employee by the 
commission under Chapter 410.
	SECTION 2.  The change in law made by this Act applies only 
to a private claim against a workers' compensation claimant based 
on a compensable injury that occurs on or after the effective date 
of this Act.  A claim based on a compensable injury that occurs 
before the effective date of this Act is governed by the law in 
effect on the date that the compensable injury occurred, and the 
former law is continued in effect for that purpose.
	SECTION 3.  This Act takes effect September 1, 2003.