TITLE 28.INSURANCE

Part 2. TEXAS WORKERS' COMPENSATION COMMISSION

Chapter 116. GENERAL PROVISIONS--SUBSEQUENT INJURY FUND

28 TAC §116.11, §116.12

The Texas Workers' Compensation Commission (the commission) proposes amendments to §116.11, concerning Request for Reimbursement or Refund from the Subsequent Injury Fund and §116.12, Subsequent Injury Fund Payment/Reimbursement

House Bill 2600 (HB-2600) passed by the 77th Texas Legislature amended Texas Labor Code §403.006 to include new liabilities for the subsequent injury fund (SIF) for claims based on compensable injuries that occur on or after July 1, 2002. The statutory amendments provided for reimbursement from the SIF for the portion of income benefits that are attributable to multiple employment and are paid pursuant to §408.042. Reimbursement was also provided for medical benefits for initial pharmaceutical services, that are paid pursuant to §413.0141 for claims later found to be non-compensable. Amendments to §116.11 and §116.12 are proposed to add these new eligible types of carrier requests for SIF reimbursement to the rules and to govern the documentation, application process, and other administrative requirements to implement the statutory provisions. The proposed amended rules address carrier requests for reimbursement, and establish the criteria for making these requests. Other commission rules address, or will address, the entitlement to the income or medical benefits.

An additional liability added to the SIF through this legislation is the payment of an assessment of feasibility and the development of regional networks established under §408.0221 of the Texas Labor Code. The cost for this liability is a one-time expense and is limited to an amount not to exceed $1.5 million. Any on going regional network administration and management services shall be included in the fees for health care services paid by insurance carriers participating in the regional networks.

The Texas Register published text shows words proposed to be added to or deleted from the current text, and should be read to determine all proposed changes.

Proposed Amendments to §116.11 - Request for Reimbursement or Refund from the Subsequent Injury Fund

Proposed amendments to §116.11(a) add multiple employment and initial pharmaceutical coverage to the list of eligible payments for which carriers may request reimbursement from the Subsequent Injury Fund. The statutory provision for reimbursement for multiple employment applies only to a compensable injury that occurs on or after July 1, 2002, and the rule reflects this.

Proposed §116.11(c) establishes a timeframe for submitting requests related to multiple employment benefits. Rather than requiring carriers to provide multiple employment benefit payments until the exhaustion of income benefits prior to submitting a request for reimbursement from the SIF, carriers will be required to file these requests annually. Carriers must submit requests for reimbursement for multiple employment claims to the Subsequent Injury Fund no later than the end of the fiscal year following the fiscal year in which such benefits were paid by the carrier. For example, requests for reimbursement for benefits paid by the carrier during fiscal year 9/1/02 through 8/31/03 must be submitted prior to 8/31/04. Requests for reimbursement may be submitted in the fiscal year in which they were paid by the carrier.

Proposed §116.11(d) establishes a timeframe for submitting requests related to initial pharmaceutical coverage. Requests pursuant to §413.0141 shall be submitted in the same or in the following fiscal year after final resolution of any dispute that determines the injury is not compensable.

Requests for reimbursement related to multiple employment and initial pharmaceutical benefits that are not submitted within the required timeframe will not be reviewed for reimbursement. In accordance with Texas Labor Code §413.0141 and HB-2600, the commission may adopt rules regarding initial pharmaceutical coverage on or after September 1, 2002. As a result, 116.11(a)(4) will not apply unless and until such a rules are adopted.

Proposed new §116.11(e)(6) describes the information and documentation required for submitting a request for reimbursement to the SIF for amounts paid pursuant to the Texas Labor Code §408.042 (relating to Average Weekly Wage for Employees with Multiple Employment). Specifically, an insurance carrier will be required to submit wage information from all multiple employment held at the time of the injured employee's on-the-job injury as well as information documenting the wage amounts and the difference, if any, between wages paid by the claim employer as defined in proposed Rule 122.5 (relating to Employee's Multiple Employment Wage Statement) and total wages from all employment

Similarly, proposed new §116.11(e)(7) outlines the requirements for requests for reimbursement pursuant to Texas Labor Code §413.0141 (relating to Initial Pharmaceutical Coverage). This subsection will require insurance carriers to submit information and documentation of payment for pharmaceuticals within the first seven days following the date of injury as well as documentation of the final resolution of any dispute which determines the injury is compensable.

In accordance with Texas Labor Code §413.0141, the commission may adopt rules regarding initial pharmaceutical coverage on or after September 1, 2002. As a result, the provisions of proposed new §116.11(e)(7) are not applicable unless and until such a rule is adopted.

Proposed Amendments to §116.12 - Subsequent Injury Fund Payment/Reimbursement Schedule

Proposed amendments to §116.12(a) add and prioritize the reimbursement of requests by carriers made pursuant to §408.042(g) of the Act relating to multiple employment and §413.0141 of the Act relating to initial pharmaceutical coverage. These two additional types of requests for reimbursement have been assigned a lesser priority as a result of the authority provided by Texas Labor Code §403.006(d) which allows the commission to make partial payment of these requests based on actuarial assessment of available funding.

Proposed subsection (e) describes the process the commission will use to calculate partial payment of requests for reimbursement for multiple employment and/or initial pharmaceutical coverage, if partial payments are necessary. If requests for reimbursements under this subsection are reimbursed with partial payment, no further future recovery will be available from the SIF for any non-reimbursed portion.

Brent Hatch, Director of Customer Services, has determined that for the first five-year period the proposed amended rules are in effect the fiscal implications for state and local governments as a result of enforcing or administering the rules are as follows: there will be an increase in administrative costs to the commission resulting from a significant increase in the number of requests for reimbursement from the SIF, which will likely require additional SIF staff to process. In addition, pursuant to §403.006(d) of the Act, the commission will also incur the cost of an actuary to provide biennial assessments of the amount of funding available prior to a commission determination that partial payments of insurance carrier claims are required. There will be no impact on state revenue.

According to the fiscal note for HB-2600, the five-year cost to the SIF in benefits is expected to be $60.8 million. The analysis of the SIF costs for that t fiscal note were based on a total of 4,387 claims eligible for such reimbursement each year.

The increase in SIF reimbursement obligations as a result of changes to the Texas Labor Code and the requirement to maintain 120% of the projected unfunded balance will likely require the assessment of an additional maintenance tax on insurance carriers. Presently, the existing assessment of maintenance tax on insurance carriers is 1.63% with a 2% statutorily established cap.

Local government and state government as a covered regulated entity will be impacted in the same manner as described later in this preamble for persons required to comply with the amended rules as proposed.

Any potential fiscal impact is largely a result of the new statutory provisions providing for reimbursements from the SIF for additional types of payments.

The need for partial payment of insurance carrier claims related to multiple employment and initial pharmaceutical coverage will be based on an actuarial assessment of the funding available for the next biennium. The rate of this assessment must be adequate to provide 120 percent of the projected unfunded liabilities. The commission's actuary or financial advisor shall report the financial condition and projected assets and liabilities of the SIF biannually (every 6 months) to the Research and Oversight Council on Workers' Compensation.

Mr. Hatch has also determined that for each year of the first five years the amended rules as proposed are in effect the public benefits anticipated as a result of enforcing the rule will be as follows.

System participants will benefit from the amended rules as proposed as a result of compliance with the changes to the Texas Labor Code and the establishment of requirements for requests for reimbursements and payment priorities.

Employees who hold multiple employment will experience an increased benefit rate as a result of the inclusion of lost wages from the multiple employment in the event they experience a compensable work-related injury. Provisions for reimbursement for initial pharmacy services payments that are made in a non-compensable injury, should reduce the likelihood that a pharmacy may decline to fill an initial prescription. This should benefit employees by securing timely medical treatment and should benefit employees and employers to the extent that timely treatment facilitates an faster return to productive work and full wages.

The proposed amended rules should reduce the number of disputes/refusals to pay for initial pharmacy services. To that extent, health care providers such as pharmacies will benefit from timely payment from carriers.

All system participants (employees, employers, health care providers, carriers) should benefit from reduced inconveniences and disputes associated with securing timely and appropriate treatment and medical benefits.

Although insurance carriers will face the potential of paying additional benefits for lost wages attributable to non-claim employment and for payment of initial seven day pharmacy services, this should not result in significant increase in costs to carriers because the additional costs are potentially reimbursable from the SIF. However, if SIF funds are not sufficient to reimburse carriers for these multiple employment and initial pharmacy payments, benefit payments by carriers will increase and this may ultimately increase premium rates for some or all employers. Insurance carriers will likely experience increased administrative costs to keep track of the carrier's payments and file requests for reimbursement, but those costs should be minimal.

There will be no anticipated economic cost for injured employees and healthcare providers as a result of this proposed rule.

There will be no difference in the costs of compliance for small businesses or micro-businesses as compared to larger businesses. There will be no adverse economic impact on small businesses or micro-businesses (see the previous economic impact analysis).

Any potential fiscal impact is largely a result of the new statutory provisions providing for reimbursements from the SIF for additional types of payments.

Comments on the proposal must be received by 5:00 p.m., April 8, 2002. You may comment via the Internet by accessing the commission's website atwww.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 Nell Cheslock, 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 subsection commented upon. The commission may not be able to respond to comments that are not 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.

A public hearing on this proposal will be held on March 21, 2002, at the Austin central office of the commission (Southfield Building, 4000 South IH-35, Austin, Texas). Those persons interested in attending the public hearing should contact the Commission's Office of Executive Communication at (512) 804-4430 to confirm the date, time, and location of the public hearing for this proposal. The public hearing schedule will also be available on the commission's website at www.twcc.state.tx.us .

The amendments are proposed under the Texas Labor Code, §401.011, which contains definitions used in the Texas Workers' Compensation Act; the Texas Labor Code, §401.024, which provides the Commission the authority to require use of facsimile or other electronic means to transmit information in the system; the Texas Labor Code §402.042, which authorizes the executive director to enter orders as authorized by the statute as well as to prescribe the form, manner and procedure for transmission of information to the Commission; Texas Labor Code, §402.061, which authorizes the commission to adopt rules necessary to administer the Act, the Texas Labor Code §§403.002 - 403.007, which address maintenance tax and the subsequent injury fund; the Texas Labor Code §406.010, which authorizes the commission to adopt rules regarding claims service, the Texas Labor Code §408.042, which pertains to average weekly wage for part-time employees or employees with multiple employment and provides for reimbursement to insurance carriers for payments attributable to multiple employment; and the Texas Labor Code §413.0141, which provides initial pharmaceutical coverage and provides for reimbursement to insurance carriers of payments made for such coverage.

The amendments are proposed under the Texas Labor Code, §401.011, §401.024, §402.042, §402.061, §§403.002 - 403.007, §406.010, §408.042, §413.0141.

No other statute, code, or article is affected by the proposed rule amendments.

§116.11. Request for Reimbursement or Refund from the Subsequent Injury Fund.

(a) A carrier may request:

(1) reimbursement from the Subsequent Injury Fund ("SIF") for an overpayment of income, death, or medical benefits when the carrier has made an unrecoupable overpayment pursuant to decision of a hearing officer or the appeals panel or an interlocutory order, and that decision or order is reversed or modified by final arbitration, order, or decision of the Commission, the State Office of Administrative Hearings, or a court of last resort; or

(2) a refund of death benefits paid to the SIF pursuant to §132.10 of this title (relating to Payment of Death Benefits to the Subsequent Injury Fund) prior to a beneficiary being eligible to receive death benefits;

(3) for a compensable injury that occurs on or after July 1, 2002: a reimbursement from the SIF for the amount of income benefits paid to a worker that is attributable to multiple employment and is paid pursuant to §408.042 relating to Multiple Employment; or

(4) a reimbursement from the SIF made in accordance with rules adopted by the Commission pursuant to §413.0141, Initial Pharmaceutical Coverage for injuries later determined not to be compensable.

(b) The amount of reimbursement that the carrier may be entitled to is equal to the amount of unrecoupable overpayments paid and does not include any amounts the carrier overpaid voluntarily or as a result of its own errors. An unrecoupable overpayment of income benefits for the purpose of reimbursement from the SIF only includes those benefits that were overpaid by the carrier pursuant to an interlocutory order or decision which were finally determined to be not owed and which, in the case of an overpayment of income benefits to the employee, were not recoverable or convertible from other income benefits.

(c) Requests for reimbursement pursuant to §408.042(g) shall be submitted on an annual basis for the payments made during the same or previous fiscal year. The fiscal year begins each September 1st and ends on August 31st of the next calendar year. For example, carrier payments made during the fiscal year from 9/1/02 through 8/31/03 must be submitted prior to 8/31/04. Any claims for carrier payments related to multiple employment that are not submitted within the required timeframe will not be reviewed for reimbursement.

(d) Requests for reimbursement pursuant to §413.0141 shall be submitted in the same or in the following fiscal year after final decision of the Commission or the court of last resort determines the injury is not compensable. The fiscal year begins each September 1st and ends on August 31st of the next calendar year. For example, if a carrier receives a final order determining a claim is not compensable during the fiscal year from 9/1/02 through 8/31/03, the request for reimbursement pursuant to §413.0141 must be submitted prior to 8/31/04. Any claims for carrier payments related to initial pharmaceutical coverage that are not submitted within the required timeframe will not be reviewed for reimbursement.

(e) [ (c) ]The request for reimbursement or refund from the SIF shall be filed with the SIF administrator and shall be in writing and include:

(1) a claim-specific summary of the reason the carrier is seeking reimbursement or refund;

(2) a detailed payment record showing the dates of payments, the amounts of the payments, the payees, and the periods of benefits paid, as well as documentation that shows that the overpayment was unrecoupable as described in subsection (b), if applicable;

(3) the name, address, and federal employer identification number of the payee for any reimbursement or refund that may be due;

(4) for requests for reimbursement of an unrecoupable overpayment made pursuant to a modified or overturned decision or interlocutory order pursuant to subsections (a)(1) and (b) of this section:

(A) a copy of the decision or interlocutory order under which the carrier made the unrecoupable overpayment and the final decision of the Commission, State Office of Administrative Hearings, or the judgment of the court of last resort that modified or overturned the decision or interlocutory order;

(B) copies of all reports by the employer including, but not limited to, the Employer's First Report of Injury, the Wage Statement, and all Supplemental Reports of Injury for overpayments of income benefits; and

(C) if an overpayment of medical benefits, copies of all medical bills and preauthorization request forms associated with the overpayment for overpayments of medical benefits;

(5) if the request is for a refund of death benefits paid to the SIF pursuant to §132.10 prior to a beneficiary being eligible to benefits, the requestor must provide copies of:

(A) the documentation the beneficiary provided with the claim for death benefits under §122.100 of this title (relating to Claim for Death Benefits); and

(B) the agreement, the final award of the Commission, or the final judgment of a court of competent jurisdiction determining that the beneficiary is entitled to the death benefits, if entitlement to benefits had been disputed; and

(6) if the request is for reimbursement for the income benefits attributable to multiple employment and paid by the carrier pursuant to Texas Labor Code §408.042 (relating to Average Weekly Wage for Employees with Multiple Employment; Collection of Wage Information), in addition to the requirements in subsection (e)(1) through (e)(3) of this section, the requestor must also include the following information and documentation :

(A) Wage information from all multiple employment held at the time of the work related injury pursuant to §122.5 of this title (relating to Employee's Multiple Employment Wage Statement);

(B) All information documenting the wage amounts and the difference, if any, between wages paid by the claim employer (as defined in §122.5 of this title ) and total wages from all employment.

(7) if the request is for reimbursement for the amounts paid pursuant to Texas Labor Code §413.0141 (relating to Initial Pharmaceutical Coverage), in addition to requirements in subsection (e)(1) through (e)(3) of this section, the requestor must also include the following information and documentation :

(A) documentation of payment of Initial Pharmaceutical Coverage (first seven days following the date of injury);

(B) documentation of the final resolution of any dispute which determines the injury is not compensable either from the Commission or court of last resort.

(8) [ (6) ]Any other documentation reasonably required by the SIF administrator to determine entitlement to reimbursement or payment from the SIF and the amount of reimbursement to which the carrier is entitled.

§116.12.Subsequent Injury Fund Payment/Reimbursement Schedule.

(a) Claims against the Subsequent Injury Fund (SIF) shall be paid in the following priority:

(1) claims by carriers for reimbursement made pursuant to §403.007 of the Act and §132.10(g) of this title (relating to Payment of Death Benefits to the Subsequent Injury Fund);

(2) claims by injured workers for lifetime benefits, as provided by §408.162 of the Act; [ and ]

(3) claims by carriers for reimbursement, made pursuant to §410.209 and §413.055 of the Act and §116.11 of this title (relating to Request for Reimbursement or Refund from the Subsequent Injury Fund). ; and

(4) claims by carriers for reimbursement made pursuant to §408.042(g) of the Act relating to multiple employment and those in accordance with commission rule(s) adopted pursuant to §413.0141 of the Act relating to initial pharmaceutical coverage.

(b) The SIF uses the fiscal year September 1 through August 31.

(c) Claims described in section (a)(1) , [ and ](a)(2) and (a)(3) may be reviewed and ordered paid by the SIF administrator at any time during the fiscal year.

(d) Following the end of the fiscal year, the administrator of the SIF shall review:

(1) the SIF available balance and projected revenues and liabilities;

(2) the current claims against the SIF, in the order of priorities set out in subsection (a) of this section; and

(3) all completed requests for reimbursement as described in §116.11 and §132.10 of this title, received during the prior fiscal year, except as provided in subsection (g) of this section.

(e) In accordance with §403.006(d) of the Act, if the commission determines that partial payments of the claims described in subsection (a)(4) of this section is necessary, partial payments shall be calculated in the following manner:

(1) The total amount of completed eligible requests for reimbursement submitted under subsection (a)(4) that are received during the previous fiscal year will be used to establish a baseline amount.

(2) The baseline amount will be divided by the total amount of SIF funding available as determined in accordance with the Act.

(3) The resulting fraction will be equally applied to all claims submitted under subsection (a)(4) to determine the partial reimbursement amount.

(4) If reimbursements requests are paid with partial payments, no further future recovery is available from the subsequent injury fund for the non-reimbursed portion of that particular request.

(f) [ (e) ] Following the end of each fiscal year, [ After review ] the SIF administrator shall, no later than October 30, enter appropriate orders for claims described in subsection (a)(3). The order shall specify the amount the SIF shall pay to the carrier.

(g) [ (f) ]The SIF administrator shall submit orders to the state comptroller for payment and send a copy of the order to the requesting carrier.

(h) [ (g) ] The SIF administrator will refrain from acting on a carrier's request for reimbursement or refund from the SIF until final resolution of the claim by a final decision of the Commission, State Office of Administrative Hearings or the court of last resort.

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 February 22, 2002.

TRD-200201098

Susan Cory

General Counsel

Texas Workers' Compensation Commission

Earliest possible date of adoption: April 7, 2002

For further information, please call: (512) 804-4287


Chapter 134. BENEFITS--GUIDELINES FOR MEDICAL SERVICES, CHARGES, AND PAYMENTS

Subchapter K. TREATMENT GUIDELINES

28 TAC §§134.1000 - 134.1003

(Editor's note: The text of the following sections proposed for repeal will not be published. The sections 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 repeal of current §134.1000, concerning the Mental Health Treatment Guideline; §134.1001, concerning the Spine Treatment Guideline; §134.1002 concerning the Upper Extremities Treatment Guideline; and §134.1003, concerning the Lower Extremities Treatment Guideline.

The repeal of §§134.1000-134.1003 is necessitated by House Bill 2600 (HB-2600), adopted during the 77th Texas Legislative Session, 2001, which states that treatment guidelines adopted under Chapter 413 of the Texas Labor Code and in effect immediately before September 1, 2001, are abolished on January 1, 2002. Sections 134.1000-134.1003 contain the treatment guidelines referred to by HB-2600. Although these treatment guidelines have already been abolished by statute effective January 1, 2002, these proposed repeals implement this legislative action by removing these guidelines from the Texas Administrative Code.

Bill DeCabooter, Acting Director of the Medical Review Division, has determined that for the first five-year period the proposed repeals are in effect there will be no fiscal implications for state or local governments as a result of enforcing or administering the repeals.

Local government and state government as covered regulated entities, will be impacted in the same manner as persons required to comply with the repeals as proposed.

Mr. DeCabooter has determined that for each year of the first five years the rule as proposed is in effect, the public benefits anticipated as a result of enforcing the rule will be the implementation of legislative action abolishing these treatment guidelines.

There will be no anticipated economic costs to persons who are required to comply with the proposed repeals. There will be no costs of compliance for small businesses. There will be no adverse economic impact on small businesses or micro-businesses. There will be no difference in the cost of compliance for small businesses as compared to large businesses.

The repeal of existing §134.1000, §134.1001, §134.1002, and §134.1003 complies with statutory mandates in the Texas Labor Code as amended by HB-2600, adopted during the 77th Texas Legislative Session. These treatment guidelines have been abolished by statute effective January 1, 2002. These repeals implement this legislative action by removing these guidelines from the Texas Administrative Code. Any impact on medical costs is due to the statute.

Comments on the proposed repeals must be received by 5:00 p.m., April 8, 2002. You may comment via the Internet by accessing the commission's website at http://www.twcc.state.tx.us and then clicking on "Proposed Rules." This medium for commenting will help you organize your comments. You may also email your comments to RuleComments@twcc.state.tx.us or mail or deliver your comments to Nell Cheslock, Legal Services, 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 section commented upon. The commission may not be able to respond to comments, which cannot be linked to a particular proposed repeal. 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. Unspecified comments submitted will not be addressed.

A public hearing on this proposal will be held on March 21, 2002, at the Austin central office of the commission (Southfield Building, 4000 South IH-35, Austin, Texas). Those persons interested in attending the public hearing should contact the Commission's Office of Executive Communication at (512) 804-4430 to confirm the date, time, and location of the public hearing for this proposal. The public hearing schedule will also be available on the commission's website at www.twcc.state.tx.us.

The repeals are proposed under: the Texas Labor Code §402.061, which authorizes the commission to adopt rules necessary to administer the Act; the Texas Labor Code §413.011 that 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 and to enhance a timely and appropriate return to work; the Texas Labor Code §413.012, which requires the Commission to review and revise medical policies and fee guidelines at least every two years to reflect current medical treatment and fees that are reasonable and necessary. HB-2600, 77th Texas Legislative Session, 2001, Article 6, Section 6.09(b), which provides that the treatment guidelines adopted under Chapter 413, Texas Labor Code, in effect immediately before September 1, 2001 are abolished on January 1, 2002

No other statute, code or article is affected by this proposal.

The repeals are proposed under: the Texas Labor Code §402.061, §413.011, §413.012, House Bill 2600, 77th Texas Legislative Session, 2001, Article 6, Section 6.09(b).

§134.1000.Mental Health Treatment Guideline.

§134.1001.Spine Treatment Guideline.

§134.1002.Upper Extremities Treatment Guideline.

§134.1003.Lower Extremities Treatment Guideline.

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 February 22, 2002.

TRD-200201095

Susan Cory

General Counsel

Texas Workers' Compensation Commission

Earliest possible date of adoption: April 7, 2002

For further information, please call: (512) 804-4287