87R6779 JSC-F
 
  By: Oliverson H.B. No. 1339
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to benefit review conferences and certain required reports
  under the Texas workers' compensation system.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 1305.502(a), Insurance Code, is amended
  to read as follows:
         (a)  Not later than December 1 of each even-numbered year,
  the [The] group shall develop and issue an [annual] informational
  report card that identifies and compares, on an objective basis,
  the quality, costs, health care provider availability, and other
  analogous factors of workers' compensation health care networks
  operating under the workers' compensation system of this state with
  each other and with medical care provided outside of networks.
         SECTION 2.  The heading to Section 410.005, Labor Code, is
  amended to read as follows:
         Sec. 410.005.  CONDUCTING [VENUE FOR] ADMINISTRATIVE
  PROCEEDINGS.
         SECTION 3.  Section 410.005, Labor Code, is amended by
  amending Subsections (a) and (d) and adding Subsection (e) to read
  as follows:
         (a)  Unless the division determines that good cause exists
  for the selection of a different location, [a benefit review
  conference or] a contested case hearing may not be conducted at a
  site more than 75 miles from the claimant's residence at the time of
  the injury.
         (d)  The [Notwithstanding Subsection (a), the] division may
  conduct a benefit review conference:
               (1)  telephonically;
               (2)  by videoconference; or
               (3)  in person, on showing of good cause as determined
  by the division [on agreement by the injured employee].
         (e)  Unless the division determines that good cause exists
  for the selection of a different location, a benefit review
  conference conducted in person under Subsection (d)(3) may not be
  conducted at a site more than 75 miles from the claimant's residence
  at the time of the injury.
         SECTION 4.  Sections 504.053(c) and (d), Labor Code, are
  amended to read as follows:
         (c)  If the political subdivision or pool provides medical
  benefits in the manner authorized under Subsection (b)(2), the
  following do not apply:
               (1)  Sections 408.004 and 408.0041, unless use of a
  required medical examination or designated doctor is necessary to
  resolve an issue relating to the entitlement to or amount of income
  benefits under this title;
               (2)  Subchapter B, Chapter 408, except for Section
  408.021;
               (3)  Chapter 413, except for Section 413.042; and
               (4)  Chapter 1305, Insurance Code, except for Sections
  [1305.501,] 1305.502[,] and 1305.503.
         (d)  If the political subdivision or pool provides medical
  benefits in the manner authorized under Subsection (b)(2), the
  following standards apply:
               (1)  the political subdivision or pool must ensure that
  workers' compensation medical benefits are reasonably available to
  all injured workers of the political subdivision or the injured
  workers of the members of the pool within a designed service area;
               (2)  the political subdivision or pool must ensure that
  all necessary health care services are provided in a manner that
  will ensure the availability of and accessibility to adequate
  health care providers, specialty care, and facilities;
               (3)  the political subdivision or pool must have an
  internal review process for resolving complaints relating to the
  manner of providing medical benefits, including an appeal to the
  governing body or its designee and appeal to an independent review
  organization;
               (4)  the political subdivision or pool must establish
  reasonable procedures for the transition of injured workers to
  contract providers and for the continuity of treatment, including
  notice of impending termination of providers and a current list of
  contract providers;
               (5)  the political subdivision or pool shall provide
  for emergency care if an injured worker cannot reasonably reach a
  contract provider and the care is for medical screening or other
  evaluation that is necessary to determine whether a medical
  emergency condition exists, necessary emergency care services
  including treatment and stabilization, and services originating in
  a hospital emergency facility following treatment or stabilization
  of an emergency medical condition;
               (6)  prospective or concurrent review of the medical
  necessity and appropriateness of health care services must comply
  with Article 21.58A, Insurance Code;
               (7)  the political subdivision or pool shall continue
  to report data to the appropriate agency as required by Title 5 of
  this code and Chapter 1305, Insurance Code; and
               (8)  a political subdivision or pool is subject to the
  requirements under Sections [1305.501,] 1305.502[,] and 1305.503,
  Insurance Code.
         SECTION 5.  The following provisions are repealed:
               (1)  Section 1305.501, Insurance Code;
               (2)  Section 2053.012, Insurance Code; and
               (3)  Sections 405.0025(b) and (c), Labor Code.
         SECTION 6.  Section 410.005, Labor Code, as amended by this
  Act, applies to a benefit review conference requested on or after
  the effective date of this Act. A benefit review conference
  requested before the effective date of this Act is governed by the
  law in effect on the date the benefit review conference was
  requested, and the former law is continued in effect for that
  purpose.
         SECTION 7.  This Act takes effect immediately if it receives
  a vote of two-thirds of all the members elected to each house, as
  provided by Section 39, Article III, Texas Constitution.  If this
  Act does not receive the vote necessary for immediate effect, this
  Act takes effect September 1, 2021.