TO: | Honorable Joe Straus, Speaker of the House, House of Representatives |
FROM: | John S O'Brien, Director, Legislative Budget Board |
IN RE: | HB2605 by Taylor, Larry (Relating to the continuation and functions of the division of workers' compensation of the Texas Department of Insurance.), As Passed 2nd House |
Fiscal Year | Probable Net Positive/(Negative) Impact to General Revenue Related Funds |
---|---|
2012 | $1,200,000 |
2013 | $1,200,000 |
2014 | $1,200,000 |
2015 | $1,200,000 |
2016 | $1,200,000 |
Fiscal Year | Probable Revenue Gain from General Revenue Fund 1 |
Probable Revenue (Loss) from Dept Ins Operating Acct 36 |
Probable Revenue Gain from Dept Ins Operating Acct 36 |
Probable Savings/(Cost) from Interagency Contracts 777 |
---|---|---|---|---|
2012 | $1,200,000 | ($1,200,000) | $1,200,000 | ($331,338) |
2013 | $1,200,000 | ($1,200,000) | $1,200,000 | ($331,338) |
2014 | $1,200,000 | ($1,200,000) | $1,200,000 | ($331,338) |
2015 | $1,200,000 | ($1,200,000) | $1,200,000 | ($331,338) |
2016 | $1,200,000 | ($1,200,000) | $1,200,000 | ($331,338) |
The bill would amend the Insurance and Labor Codes relating to the continuation and functions of the division of workers' compensation (DWC) of the Texas Department of Insurance (TDI). DWC has a separate Sunset date from TDI, and will be abolished on September 1, 2011, unless continued by the Legislature. The bill would continue DWC for 6 years and take effect on September 1, 2011.
The bill would require parties to non-network medical fee disputes to attempt low-level mediation at DWC before appealing to the contested case hearing level and would require DWC to conduct all medical necessity contested case hearings and the State Office of Administrative Hearings (SOAH) to conduct all medical fee contested case hearings. The bill would require DWC to develop guidelines for the contested case hearings process and make them publicly available. The bill would require DWC to develop minimum qualification and training requirements for Medical Quality Review Panel members and establishes the Quality Assurance Panel in statute and clarifies its involvement in the process. The bill would authorize the Commissioner of Workers’ Compensation to make final decisions on cases involving monetary penalties and requires all administrative penalties to be deposited in the General Revenue Fund instead of the General Revenue – Dedicated Fund 36 TDI Operating Account (GR-D 36). The bill would strengthen Designated Doctor requirements to ensure DWC can use their expert medical opinions effectively in disputes. The bill would allow doctors that were previously removed from the Approved Doctors List to be reinstate to the workers' compensation system. The bill would establish an expedited claim process for first responders who are employed by or volunteer for a political subdivision and sustain a serious work-related injury and would require DWC to solicit proposals or applications from independent training and testing providers when contracting for Designated Doctor training and testing providers, and would require that DWC place the contracts on its website. The bill would align the appeals process for medical necessity disputes for all workers' compensation claims.
The bill would require the agencies that regulate health professionals who are involved in the provision of health care as part of the workers’ compensation system in this state to develop lists of health care providers who have demonstrated experience in workers’ compensation to be used to potentially appoint members o the medical quality review panel. The bill would amend statute relating to certain actions against an employer by an employee who is not covered by workers' compensation insurance.
The bill would require the insurance carrier to pay for the cost of an additional examination of an employee after any designated doctor examination to determine any issue upon which the designated doctor opined. The bill would require that the cost of that additional examination is to be borne by the insurance carrier.
This bill would provide for an examination after any designated doctor examination that is the employee’s first determination of maximum medical improvement and impairment rating with which the employee is dissatisfied; and would direct the commissioner to adopt guidelines prescribing circumstances where an employee is entitled to a post designated doctor examination on other issues decided by the designated doctor.
The bill states that the changes to statute regarding the appeal of a medical fee dispute apply only to medical fee disputes based on a review conducted by DWC on or after the effective date of the bill. The bill would take effect September 1, 2011.
No fiscal implication to units of local government is anticipated.
Source Agencies: | 116 Sunset Advisory Commission, 360 State Office of Administrative Hearings, 454 Department of Insurance, 479 State Office of Risk Management, 304 Comptroller of Public Accounts, 503 Texas Medical Board, 504 Texas State Board of Dental Examiners, 507 Texas Board of Nursing, 508 Board of Chiropractic Examiners, 512 Board of Podiatric Medical Examiners, 515 Board of Pharmacy, 520 Board of Examiners of Psychologists, 533 Executive Council of Physical Therapy & Occupational Therapy Examiners
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LBB Staff: | JOB, KM, MW, CH, SD, KJG, NV, EH
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