Bill Text: TX HB2919 | 2019-2020 | 86th Legislature | Comm Sub
Bill Title: Relating to a demonstration program at the State Office of Risk Management for real-time processing of workers' compensation authorizations of payment for medical services and medical bills.
Spectrum: Partisan Bill (Republican 3-0)
Status: (Introduced - Dead) 2019-05-03 - Committee report sent to Calendars [HB2919 Detail]
Download: Texas-2019-HB2919-Comm_Sub.html
| 86R29669 KKR-D | |||
| By: Shine, Darby, Parker | H.B. No. 2919 | ||
| Substitute the following for H.B. No. 2919: | |||
| By: Darby | C.S.H.B. No. 2919 | ||
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| relating to a demonstration program at the State Office of Risk | ||
| Management for real-time processing of workers' compensation | ||
| authorizations of payment for medical services and medical bills. | ||
| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
| SECTION 1. Subchapter B, Chapter 412, Labor Code, is | ||
| amended by adding Section 412.0129 to read as follows: | ||
| Sec. 412.0129. AUTHORIZATION OF PAYMENT FOR MEDICAL | ||
| SERVICES AND MEDICAL BILLS REAL-TIME PROCESSING DEMONSTRATION | ||
| PROGRAM. (a) The office may develop and implement a demonstration | ||
| program for processing workers' compensation authorizations of | ||
| payment for medical services and medical bills in real time if the | ||
| office determines that the program would be cost-effective. | ||
| (b) The demonstration program described by Subsection (a) | ||
| must include: | ||
| (1) a secure single platform, Internet-based portal | ||
| for use by the office, state agencies, injured employees, and | ||
| health care providers; | ||
| (2) the ability to collect, input, and transmit | ||
| administrative and clinical data, including: | ||
| (A) patient information; | ||
| (B) provider contracts; | ||
| (C) treatment guidelines; and | ||
| (D) other information the office considers | ||
| necessary for processing authorizations and medical bills; | ||
| (3) an automated process to streamline requests for | ||
| authorizations of payment for medical services and peer reviews at | ||
| the point of care; and | ||
| (4) return-to-work best practices for workers' | ||
| compensation claims, including complex case management. | ||
| (c) The workers' compensation research and evaluation group | ||
| may assist the office in identifying and adopting measures for | ||
| evaluating the demonstration program. | ||
| (d) The evaluation period for the demonstration program | ||
| shall end on June 30, 2022. | ||
| (e) If the office implements a demonstration program under | ||
| this section, not later than December 31, 2022, the office shall | ||
| provide to the board a report that: | ||
| (1) evaluates the program, including any effects of | ||
| the program on administrative cost savings; and | ||
| (2) recommends whether to use the process implemented | ||
| under the program on a permanent basis. | ||
| (f) If the report of the demonstration program under | ||
| Subsection (e) indicates that administrative cost savings are | ||
| achieved by the process implemented under the program, the board | ||
| may adopt and use the process on a permanent basis. | ||
| (g) If the report of the demonstration program under | ||
| Subsection (e) indicates that administrative cost savings were not | ||
| achieved by the process implemented under the program, not later | ||
| than December 31, 2022, the office shall submit to the legislature a | ||
| written report that contains: | ||
| (1) the reasons that the program did not result in | ||
| administrative cost savings; and | ||
| (2) recommendations for proposed legislation to | ||
| develop a cost-effective system for processing workers' | ||
| compensation authorizations of payment for medical services and | ||
| medical bills in real time. | ||
| (h) This section expires September 1, 2023. | ||
| SECTION 2. Not later than January 1, 2020, the State Office | ||
| of Risk Management shall study and make a determination as to | ||
| whether the demonstration program described by Section 412.0129, | ||
| Labor Code, as added by this Act, would be cost-effective. If the | ||
| office determines the program would be cost-effective and decides | ||
| to implement the program, the office shall fully implement the | ||
| program not later than January 1, 2021. | ||
| SECTION 3. 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, 2019. | ||
