TITLE 28.INSURANCE

Part 2. TEXAS WORKERS' COMPENSATION COMMISSION

Chapter 126. GENERAL PROVISIONS APPLICABLE TO ALL BENEFITS

28 TAC §126.8

The Texas Workers' Compensation Commission (the commission) adopts amendments to §126.8 concerning the Commission-Approved Doctor List without changes to the proposed text published in the (March 9, 2001) issue of the Texas Register (26 TexReg 2002). These amendments are adopted to correct and update references to rules and laws that have been recodified.

As required by the Government Code §2001.033(1), the commission's reasoned justification for this rule is set out in this order which includes the preamble, which in turn includes the rule. This preamble contains a summary of the factual basis of the rule, a summary of comments received from interested parties, names of those groups and associations who commented and whether they were for or against adoption of the rule, and the reasons why the commission disagrees with some of the comments and proposals.

In 1993, the rule was proposed to establish criteria, in addition to those criteria specified in Texas Civil Statutes, Article (8308-4.63) for the addition of doctors and for the removal of doctors from the list. This section was required by Texas Civil Statutes, Article 8308-4.63 (now the Texas Labor Code §408.023). The duty to conduct hearings under the Administrative Procedure Act was first located in the commission's Division of Hearings. In 1995, the Texas Legislature moved this duty to the State Office Administrative Hearings effective January 1, 1996. The commission adopted the rules in Chapters 148 and 149 to implement this change. For this reason references to the Chapter 145 rules should be replaced with references to the rules in Chapter 148, relating to Hearings Conducted by the State Office of Administrative Hearings.

Also in 1993, the Texas Legislature incorporated the Texas Workers' Compensation Act into the Texas Labor Code, Title 5, Subtitle A. Reference to Articles 8308-4.63 corresponds now to §408.023 of the Texas Labor Code (relating to Contested Cases: General Rights and Procedures, Opportunity for Hearing and Participation); therefore, these references should be revised accordingly.

The Texas Legislature incorporated the Administrative Procedure and Texas Register Act into the Texas Government Code in 1993 as well. Therefore, the reference to Article 6252-13a (the Administrative Procedure and Texas Register Act) should be changed to §2001.051 of the Texas Government Code (and the reference to Article 8308-2.09 (f), relating to the powers and duties of the Commission corresponds to §402.072 of the Texas Labor Code).

Comments opposing certain portions of §126.8 and a comment seeking clarification were received from the following groups, associations and individuals: William M. Leff, D.C., Eric Scheffey, M. D., East Harris County Orthopedic Associates, P. A., and Bill Elliott, Compliance Manager of ARCMI. Summaries of the comments and commission responses are as follows:

COMMENT: Commenter felt that the proposed rule change was hard to understand and suggested that some explanation, not necessarily a part of the rule, should accompany the proposal.

RESPONSE: The commission disagrees that the proposed changes are unclear. The preamble to the proposed rule explains that the proposed amendments correct and update references to rules and laws that have been changed since the rule was adopted. Each rule and law that was changed is identified.

COMMENT: Commenters disagreed with the reasons in subsection (d)(3), (5), and (6) of the rule for deleting doctors from the list.

RESPONSE: These comments are outside of the scope of the rule proposal. No changes to subsection (d) were proposed and no changes to that subsection are being considered at this time.

COMMENT: Commenter expressed concern about subsection (b) which states that payment cannot be withheld from doctors in other jurisdictions because they are not on the approved doctor list. Commenter asked if this provision applied to doctors in Mexico with whom a substantial number of claimants seek treatment to avoid providing accurate and current information to the workers compensation carrier.

RESPONSE: This comment is outside the scope of the rule proposal. No changes to subsection (b) were proposed and no changes to that subsection are being considered at this time.

The amended rule is adopted under the Texas Labor Code, §402.061, which authorizes the commission to adopt rules necessary to administer the Act, the Texas Labor Code §402.073, relating to the Cooperation with the State Office of Administrative Hearings, the Texas Labor Code §408.023, relating to the List of Approved Doctors, and Chapter 2001 of the Texas Government Code, relating to hearings before the State Office of Administrative Hearings.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on May 18, 2001.

TRD-200102808

Susan Cory

General Counsel

Texas Workers' Compensation Commission

Effective date: June 7, 2001

Proposal publication date: March 9, 2001

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