Texas Register Table of Contents
- 1 Texas Department of Insurance, Division of Worker’s Compensation
- 1.0.1 Proposed Rules Re:
- 1.0.1.1 Amending 28 TAC §133.240, §133.250, to correct typos and to add the requirement that insurance carriers must give priority and accelerate to a member of the Texas military forces’s qualifying claim for medical benefits.
- 1.0.1.2 Amending 28 TAC §133.305, §133.308, to clarify when the travel of a member of the Texas military forces to or from the member’s duty location is considered to be in the course and scope of the member’s employment.
- 1.0.1.3 Amending 28 TAC §134.600, to require insurance carriers to accelerate and give priority to a qualifying claim for medical benefits by a member of the Texas military forces.
- 1.0.1 Proposed Rules Re:
- 2 Texas Health and Human Services Commission
Texas Department of Insurance, Division of Worker’s Compensation
Proposed Rules Re:
Amending 28 TAC §133.240, §133.250, to correct typos and to add the requirement that insurance carriers must give priority and accelerate to a member of the Texas military forces’s qualifying claim for medical benefits.
CHAPTER 133. GENERAL MEDICAL PROVISIONS
SUBCHAPTER C. MEDICAL BILL PROCESSING/AUDIT BY INSURANCE CARRIER
28 TAC §133.240, §133.250
OVERVIEW
The Texas Department of Insurance, Division of Workers’ Compensation (DWC) proposes to amend 28 TAC §§133.240, 133.250, 133.305, and 133.308, concerning medical disputes for workers’ compensation claims. The amendments implement House Bill (HB) 90, 88th Legislature, Regular Session (2023).
BACKGROUND AND JUSTIFICATION
HB 90 added Labor Code §§401.027, 501.027, 501.028, and 501.029; and amended Labor Code §501.001. The proposed amendments to §§133.240, 133.250, 133.305, and 133.308 are necessary to implement the changes in HB 90 by clarifying workers’ compensation coverage for authorized travel by members of the Texas military forces, ensuring that insurance carriers expedite claims for medical benefits by injured members of the Texas military forces, and ensuring that DWC expedites disputes about those claims. The proposed amendments also include an update to the agency’s address and nonsubstantive editorial and formatting changes that make updates for plain language and agency style to improve the rule’s clarity.
SECTION-BY-SECTION SUMMARY
- Section 133.240. The amendments to §133.240 correct typos in existing text and add the requirement from HB 90 that an insurance carrier must accelerate and give priority to a qualifying claim for medical benefits by a member of the Texas military forces, including all required health care for the claim. Amending §133.240 is necessary to ensure that the rule is consistent with HB 90.
- Section 133.250. The amendments to §133.250 correct typos in existing text and add the requirement from HB 90 that an insurance carrier must accelerate and give priority to a qualifying claim for medical benefits by a member of the Texas military forces, including all required health care for the claim. Amending §133.250 is necessary to ensure that the rule is consistent with HB 90.
Amending 28 TAC §133.305, §133.308, to clarify when the travel of a member of the Texas military forces to or from the member’s duty location is considered to be in the course and scope of the member’s employment.
CHAPTER 133. GENERAL MEDICAL PROVISIONS
SUBCHAPTER D. DISPUTE OF MEDICAL BILLS
28 TAC §133.305, §133.308
OVERVIEW
The Texas Department of Insurance, Division of Workers’ Compensation (DWC) proposes to amend 28 TAC §§133.240, 133.250, 133.305, and 133.308, concerning medical disputes for workers’ compensation claims. The amendments implement House Bill (HB) 90, 88th Legislature, Regular Session (2023).
BACKGROUND AND JUSTIFICATION
HB 90 added Labor Code §§401.027, 501.027, 501.028, and 501.029; and amended Labor Code §501.001. The proposed amendments to §§133.240, 133.250, 133.305, and 133.308 are necessary to implement the changes in HB 90 by clarifying workers’ compensation coverage for authorized travel by members of the Texas military forces, ensuring that insurance carriers expedite claims for medical benefits by injured members of the Texas military forces, and ensuring that DWC expedites disputes about those claims. The proposed amendments also include an update to the agency’s address and nonsubstantive editorial and formatting changes that make updates for plain language and agency style to improve the rule’s clarity.
SECTION-BY-SECTION SUMMARY
- Section 133.305. The amendments to §133.305 add references to the definitions in Government Code §437.001 for “state active duty,” “state training and other duty,” and “Texas military forces.” The amendments also add the requirement from HB 90 that, for a claim under Labor Code §501.028, the travel of a member of the Texas military forces to or from the member’s duty location is considered to be in the course and scope of the member’s employment if the member is serving on state active duty and engaged in authorized duty under written orders, or is on state training and other duty. Amending §133.305 is necessary to ensure that the rule is consistent with HB 90.
- Section 133.308. The amendments to §133.308 update the address for the Managed Care Quality Assurance (MCQA) Office at the Texas Department of Insurance. The amendments also add the requirement from HB 90 that DWC will accelerate and give priority to an appeal from a denial of a qualifying claim for medical benefits made by a member of the Texas military forces, as well as to actions involving all health care required to cure or relieve the effects naturally resulting from a compensable injury. The amendments add the requirement from HB 90 that the member must notify DWC and the independent review officer that the contested case hearing or appeal involves a member of the Texas military forces. Amending §133.308 is necessary to ensure that the rule contains the current MCQA office address and that it is consistent with HB 90.
Amending 28 TAC §134.600, to require insurance carriers to accelerate and give priority to a qualifying claim for medical benefits by a member of the Texas military forces.
CHAPTER 134. BENEFITS–GUIDELINES FOR MEDICAL SERVICES, CHARGES, AND PAYMENTS
SUBCHAPTER G. PROSPECTIVE AND CONCURRENT REVIEW OF HEALTH CARE
28 TAC §134.600
OVERVIEW
The Texas Department of Insurance, Division of Workers’ Compensation (DWC) proposes to amend 28 TAC §134.600, concerning preauthorization, concurrent utilization review, and voluntary certification of health care. The amendments implement House Bill (HB) 90, 88th Legislature, Regular Session (2023).
BACKGROUND AND JUSTIFICATION
HB 90 added Labor Code §§401.027, 501.027, 501.028, and 501.029; and amended Labor Code §501.001. The proposed amendments to §134.600 are necessary to implement the changes in HB 90 by ensuring that insurance carriers expedite claims for medical benefits by injured members of the Texas military forces, including all health care required for the compensable injury. The proposed amendments also include nonsubstantive editorial and formatting changes that make updates for plain language and agency style to improve the rule’s clarity.
SECTION-BY-SECTION SUMMARY
Section 134.600. The amendments to §134.600 correct typos in existing text and add the requirement from HB 90 that an insurance carrier must accelerate and give priority to a qualifying claim for medical benefits by a member of the Texas military forces, including all required health care for the claim. Amending §134.600 is necessary to ensure that the rule is consistent with HB 90.
Texas Health and Human Services Commission
Adopted Rules Re:
CHAPTER 351. COORDINATED PLANNING AND DELIVERY OF HEALTH AND HUMAN SERVICES
SUBCHAPTER B. ADVISORY COMMITTEES
1 TAC §351.823
OVERVIEW
The Texas Health and Human Services Commission (HHSC) adopts an amendment to §351.823, concerning the e-Health Advisory Committee. The amendment to §351.823 is adopted with changes to the proposed text as published in the July 14, 2023, issue of the Texas Register (48 TexReg 3790). The rule will be republished.
BACKGROUND AND JUSTIFICATION
The e-Health Advisory Committee (eHAC) was established in 2016 by the HHSC Executive Commissioner, under the authority of Texas Government Code §531.012. This statute requires the HHSC Executive Commissioner to establish and maintain advisory committees; establish rules for the operation of advisory committees; and for advisory committees to provide recommendations to the executive commissioner and the Texas Legislature.
The eHAC advises the HHSC Executive Commissioner and Health and Human Services (HHS) agencies on strategic planning, policy, rules, and services related to the use of health information technology, health information exchange systems, telemedicine, telehealth, and home telemonitoring services. Members meet approximately four times per year in Austin, at the discretion of the eHAC Chair.
Proposed Rule Reviews Re:
Reviewing Title 26, Part 1, to consider for readoption, revision, or repeal the chapter concerning Independent Living Services.
The Texas Health and Human Services Commission (HHSC) proposes to review and consider for readoption, revision, or repeal the chapter listed below, in its entirety, contained in Title 26, Part 1, of the Texas Administrative Code:
Chapter 357, Independent Living Services
Subchapter A General Rules
Subchapter B Allocation of Funds
Subchapter C Independent Living Services
Subchapter D Consumer Participation
Subchapter E Consumer Rights
Subchapter F Technical Assistance and Training
Subchapter G Referrals