28 TAC §134.2
(Editor's note: The text of the following section proposed for
repeal will not be published. The section may be examined in the offices of
the Texas Workers' Compensation Commission or in the Texas Register office,
Room 245, James Earl Rudder Building, 1019 Brazos Street, Austin.)
The Texas Workers' Compensation Commission (the
Commission) proposes the repeal §134.2, concerning Insurance Carrier
Responsibility to Submit Medical Reports.
The Commission proposes the repeal to eliminate redundancy in the rules.
Newly adopted §102.9 of this title (relating to Submission of Information
Requested by the Commission) makes current §134.2 unnecessary.
Victor Rodriguez, Chief Financial Officer, has determined that the proposed
repeal will have no fiscal implications for state or local governments.
The impact to local government and state government as covered regulated
entities is the same as described later in this preamble for persons required
to comply with the repeal.
Mr. Rodriguez has also determined that for each year of the first five
years the repeal is in effect the public benefits anticipated as a result
of the repeal will be elimination of redundant provisions in the rules. There
will be no anticipated economic costs to persons who are required to comply
with the repeal of the rule as proposed. There will be no adverse economic
impact on small businesses and micro-businesses.
Comments on the proposal must be received by 5:00 p.m., June 5, 2000. You
may comment via the Internet by accessing the Commission's website at www.twcc.state.tx.us
and then clicking on "Proposed Rules." This medium for commenting will help
you organize your comments by rule chapter. You may also comment by emailing
your comments to RuleComments@twcc.state.tx.us or by mailing or delivering
your comments to Sue Cutler at the Office of the General Counsel, Mailstop
#4-D, Texas Workers' Compensation Commission, Southfield Building, 4000 South
IH-35, Austin, Texas 78704-7491.
Commenters are requested to clearly identify by number the specific rule
and paragraph commented upon. The Commission may not be able to respond to
comments that cannot be linked to a particular proposed rule. Along with your
comment, it is suggested that you include the reasoning for the comment in
order for Commission staff to fully evaluate your recommendations.
Based upon various considerations, including comments received and the
staff's or commissioners' review of those comments, or based upon the commissioners'
action at the public meeting, the rule as adopted may be revised from the
rule as proposed in whole or in part. Persons in support of the rule as proposed,
in whole or in part, may wish to comment to that effect.
The repeal is proposed under the Texas Labor Code, §402.061,
which authorizes the Commission to adopt rules necessary to administer the
Act; the Texas Labor Code §406.010 which authorizes the Commission to
adopt rules necessary to specify the requirements for carriers to provide
claims service and establishes that a person commits a violation if the person
violates a rule adopted under this section; the Texas Labor Code §413.002,
which requires the Commission to monitor health care providers and insurance
carriers to ensure compliance with Commission rules relating to health care;
the Texas Labor Code §413.007, which requires the Commission to maintain
a statewide database of medical charges, actual payments, and treatment protocols;
the Texas Labor Code §413.011, which requires the Commission by rule
to establish medical policies relating to necessary treatments for injuries
and designed to ensure the quality of medical care and to achieve effective
medical cost control; the Texas Labor Code §413.012, which requires the
Commission to review and revise medical policies and fee guidelines to reflect
current medical treatment and fees that are reasonable and necessary; and
the Texas Labor Code §413.013, which requires the Commission to establish
a program for the systematic monitoring of the necessity of the treatments
administered and fees charged and paid for medical treatments or services,
including the authorization of prospective, concurrent, or retrospective review
under the medical policies of the Commission to ensure the medical policies
and guidelines are not exceeded, and a program to detect practices and patterns
by insurance carriers in unreasonably denying authorization of payment for
medical services requested or performed if authorization is required by the
medical policies of the Commission.
The proposed repeal affects the following statutes: the Texas Labor Code, §402.061,
which authorizes the Commission to adopt rules necessary to administer the
Act; the Texas Labor Code §406.010 which authorizes the Commission to
adopt rules necessary to specify the requirements for carriers to provide
claims service and establishes that a person commits a violation if the person
violates a rule adopted under this section; the Texas Labor Code §413.002,
which requires the Commission to monitor health care providers and insurance
carriers to ensure compliance with Commission rules relating to health care;
the Texas Labor Code §413.007, which requires the Commission to maintain
a statewide database of medical charges, actual payments, and treatment protocols;
the Texas Labor Code §413.011, which requires the Commission by rule
to establish medical policies relating to necessary treatments for injuries
and designed to ensure the quality of medical care and to achieve effective
medical cost control; the Texas Labor Code §413.012, which requires the
Commission to review and revise medical policies and fee guidelines to reflect
current medical treatment and fees that are reasonable and necessary; and
the Texas Labor Code §413.013, which requires the Commission to establish
a program for the systematic monitoring of the necessity of the treatments
administered and fees charged and paid for medical treatments or services,
including the authorization of prospective, concurrent, or retrospective review
under the medical policies of the Commission to ensure the medical policies
and guidelines are not exceeded, and a program to detect practices and patterns
by insurance carriers in unreasonably denying authorization of payment for
medical services requested or performed if authorization is required by the
medical policies of the Commission.
§134.2. Insurance Carrier Responsibility to Submit Medical Reports.
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed with the Office of
the Secretary of State, on April 20, 2000.
TRD-200002820
Susan Cory
General Counsel
Texas Workers' Compensation Commission
Earliest possible date of adoption: June 4, 2000
For further information, please call: (512) 804-4287