2003S1198-1 04/28/03


By:  Van de Putte, Harris                                       S.C.R. No. 48 
 
    Ratliff                                                                  



CONCURRENT RESOLUTION
	WHEREAS, The integrity of the Texas workers' compensation 
system must be protected so that injured workers have ready access 
to medically necessary health care services, including medically 
necessary prescription drugs; and
	WHEREAS, The current statutory, regulatory, and 
administrative guidelines for determining payment amounts for 
prescription drugs under the Labor Code are vague and do not provide 
fair notice to providers and workers' compensation insurance 
carriers regarding the amounts to be billed and paid; and
	WHEREAS, The methodology for determining payment amounts for 
prescription drugs under state law should be clearly defined; and
	WHEREAS, In order to ensure the presence of a reliable 
network of pharmacy providers and workers' compensation insurance 
carriers for injured workers in Texas, the procedures for 
presenting and processing claims for prescription drugs under the 
Labor Code should be made more efficient and less burdensome on 
insurance carriers and pharmacy providers; and
	WHEREAS, Workers' compensation insurance carriers and 
pharmacy providers throughout Texas are working collaboratively 
toward the goals set forth in this resolution; now, therefore, be it
	RESOLVED, That the 78th Legislature of the State of Texas 
hereby direct the Texas Workers' Compensation Commission to 
complete, not later than December 1, 2003, a study of the additional 
administrative costs and expenses incurred by pharmacy providers to 
process claims and payments for prescription drugs provided to 
individuals under the Texas workers' compensation system, relative 
to the costs and expenses incurred in providing such drugs to 
self-paying individuals or individuals for whom payment is made 
under insurance coverage other than workers' compensation 
insurance; and, be it further
	RESOLVED, That the 78th Legislature of the State of Texas 
hereby direct the Texas Workers' Compensation Commission to 
promulgate, not later than December 1, 2003, regulations that 
clearly define the methodology for determining payment amounts for 
prescription drugs under the Texas Workers' Compensation Act, and 
in so doing, to take into account the additional costs and expenses 
that workers' compensation insurance carriers and pharmacies incur 
in providing prescription drugs to individuals under the Labor Code 
and to ensure the presence of a reliable network of pharmacy 
providers for injured workers in Texas; and, be it further
	RESOLVED, That the 78th Legislature of the State of Texas 
hereby direct the Texas Workers' Compensation Commission to pursue 
efforts to streamline the procedures for presenting, processing, 
and paying claims for prescription drugs under the Labor Code 
through the development of a system more efficient than the one 
currently in place; and, be it further
	RESOLVED, That the 78th Legislature of the State of Texas 
hereby direct the Texas Workers' Compensation Commission to 
implement this resolution in a budget-neutral manner, and to 
employ, as appropriate, studies or other research funded by 
collaborative efforts of workers' compensation insurance carriers 
and pharmacy providers; and, be it further
	RESOLVED, That the secretary of state forward an official 
copy of this resolution to the commissioner of the Texas Workers' 
Compensation Commission.