Bill Text: TX HB3429 | 2011-2012 | 82nd Legislature | Introduced
Bill Title: Relating to preauthorization of certain medical services in the workers' compensation system and the eligibility of doctors, dentists, and chiropractors to perform preauthorization utilization review.
Sponsorship: Partisan Bill (Republican 1)
Status: (Introduced - Dead) 2011-03-18 - Referred to State Affairs [HB3429 Detail]
Download: Texas-2011-HB3429-Introduced.html
| 82R8683 JSC-D | ||
| By: Zedler | H.B. No. 3429 | |
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| relating to preauthorization of certain medical services in the | ||
| workers' compensation system and the eligibility of doctors, | ||
| dentists, and chiropractors to perform preauthorization | ||
| utilization review. | ||
| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
| SECTION 1. Section 1305.351, Insurance Code, is amended by | ||
| adding Subsection (e) to read as follows: | ||
| (e) If a network or insurance carrier uses a | ||
| preauthorization process within the network, not later than the | ||
| 30th day after the date of making a decision regarding a request for | ||
| preauthorization, the network or carrier shall submit to the | ||
| division of workers' compensation of the department: | ||
| (1) a statement of: | ||
| (A) whether the network or carrier approved, | ||
| approved in part, or denied the request for preauthorization; and | ||
| (B) the reason the network or carrier made the | ||
| decision under Paragraph (A); and | ||
| (2) any relevant supporting material, including any | ||
| reports by medical professionals who reviewed the case. | ||
| SECTION 2. Section 408.0043, Labor Code, is amended by | ||
| adding Subsection (c) to read as follows: | ||
| (c) A doctor who performs preauthorization utilization | ||
| review for an insurance network or carrier must: | ||
| (1) maintain the doctor's primary practice location in | ||
| this state; and | ||
| (2) earn at least 50 percent of the doctor's annual | ||
| income from the practice of treating patients. | ||
| SECTION 3. Section 408.0044, Labor Code, is amended by | ||
| adding Subsection (c) to read as follows: | ||
| (c) A dentist who performs preauthorization utilization | ||
| review for an insurance network or carrier must: | ||
| (1) maintain the dentist's primary practice location | ||
| in this state; and | ||
| (2) earn at least 50 percent of the dentist's annual | ||
| income from the practice of treating patients. | ||
| SECTION 4. Section 408.0045, Labor Code, is amended by | ||
| adding Subsection (c) to read as follows: | ||
| (c) A chiropractor who performs preauthorization | ||
| utilization review for an insurance network or carrier must: | ||
| (1) maintain the chiropractor's primary practice | ||
| location in this state; and | ||
| (2) earn at least 50 percent of the chiropractor's | ||
| annual income from the practice of treating patients. | ||
| SECTION 5. Section 413.014, Labor Code, is amended by | ||
| adding Subsection (g) to read as follows: | ||
| (g) Not later than the 30th day after the date of making a | ||
| decision regarding a request for preauthorization, the insurance | ||
| carrier shall submit to the division: | ||
| (1) a statement of: | ||
| (A) whether the carrier approved, approved in | ||
| part, or denied the request for preauthorization; and | ||
| (B) the reason the carrier made the decision | ||
| under Paragraph (A); and | ||
| (2) any relevant supporting material, including any | ||
| reports by medical professionals who reviewed the case. | ||
| SECTION 6. The change in law made by this Act applies to a | ||
| preauthorization request in connection with a claim for workers' | ||
| compensation benefits that is made on or after the effective date of | ||
| this Act. A preauthorization request that was made before that date | ||
| is governed by the law in effect when the request was made, and the | ||
| former law is continued in effect for that purpose. | ||
| SECTION 7. This Act takes effect September 1, 2011. | ||
