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.