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78R5332 PB-F

By:  Ellis                                                        S.B. No. 603



A BILL TO BE ENTITLED

AN ACT

relating to overcharging by health care providers under the 
workers' compensation system; providing criminal penalties.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:                        
	SECTION 1.  Section 413.043, Labor Code, is amended by 
amending Subsection (b) and by adding Subsections (c) and (d) to 
read as follows:
	(b)  If the difference between the amount charged the 
insurance carrier by the health care provider and the amount 
normally charged for similar treatment to a payor outside the 
workers' compensation system [An offense under this section] is:
		(1)  less than $20, an offense under this section is a 
Class C misdemeanor;
		(2)  $20 or more but less than $500, an offense under 
this section is a Class B misdemeanor;
		(3)  $500 or more but less than $1,500, an offense under 
this section is a Class A misdemeanor;
		(4)  $1,500 or more but less than $20,000, an offense 
under this section is a state jail felony;
		(5)  $20,000 or more but less than $100,000, an offense 
under this section is a felony of the third degree;
		(6)  $100,000 or more but less than $200,000, an 
offense under this section is a felony of the second degree; or
		(7)  $200,000 or more, an offense under this section is 
a felony of the first degree.
	(c)  If a health care provider obtains payments for services 
in violation of Subsection (a) under one scheme or a continuing 
course of conduct, whether from one source or several sources, the 
conduct may be considered one offense and the amounts aggregated in 
determining the classification of the offense.
	(d)  An offense under this section may be prosecuted in:                
		(1)  Travis County;                                                    
		(2)  a county in which any element of the offense 
occurs; or         
		(3)  the county of the insurance carrier's principal 
office in this state.
	SECTION 2.  (a)  The change in law made by this Act applies 
only to the punishment for an offense committed on or after the 
effective date of this Act.  For purposes of this section, an 
offense is committed before the effective date of this Act if any 
element of the offense occurs before the effective date.
	(b)  An offense committed before the effective date of this 
Act is governed by the law in effect on the date that the offense was 
committed, and the former law is continued in effect for that 
purpose.
	SECTION 3.  This Act takes effect September 1, 2003.