The Texas House of Representatives passed legislation, House Bill 7, designed to overhaul the workers’ compensation system by creating medical networks to help rein in the skyrocketing costs and get injured workers the care they need to return to work.
According to Property Casualty Insurers Association of America, HB 7 reflects the recommendations of the Texas Sunset Advisory Commission, which focused on helping injured workers get quality health care and return to work, while controlling costs. The recommendations included restructuring the workers’ compensation system to operate similarly to group health insurance, and instituting a variety of cost containment practices.
The bill would abolish the Texas Workers’ Compensation Commission, establish the Office of Injured Employee Public Counsel and transfer the duties of the commission to the Texas Department of Insurance and the Office of Injured Employee Public Counsel. In addition, the legislation would address dispute resolution and medical networks.
“We commend Rep. Burt Solomons (R-Carrollton) and other House members for developing legislation that will bring meaningful reform to the workers compensation system,” said Joe Woods, assistant vice president and regional manager for PCI. “Over the past few years, the biggest problem with the Texas workers’ compensation system has been abuse in the delivery of medical costs. This has resulted in Texas having the highest per injury medical costs and one of the worst return-to-work outcomes in the United States. The move to medical networks will create a system where appropriate care can be provided to improve the return-to-work rate and result in substantial savings in medical costs.”
PCI supports abolition of the six-member Texas Workers’ Compensation Commission and placing control of workers’ compensation in the hands of one person who is accountable to the governor and the Legislature. PCI also applauds the streamlined dispute resolution process and the changes to medical networks for medical care within the system. These networks would provide injured workers a choice of qualified, credentialed medical doctors to serve as their primary doctor and lead to better health outcomes as treating physicians, workers and employers will be more familiar with job-related injuries and the best treatment options for those injuries
During the floor debate, Rep. Solomons was successful in defeating an amendment that would have opened the networks up to any doctor willing to provide services and would have moved prompt pay deadlines to unworkable timelines. The amendment died on an 85-55 vote. Under the current law, injured workers can select any doctor willing to provide service who is on the TWCC’s Approved Doctor List. This has contributed significantly to the state’s high medical costs and poor rate of workers returning to work.
“Adopting the any willing provider amendment would have cut the “heart and soul” out of this reform legislation. Allowing any and all providers to be included in the networks negates the purpose of the network approach and would have ultimately produced a result that is no different from and possibly worse than the current system,” said Woods.
The House (HB 7) and Senate (SB 5) have each passed versions of workers’ compensation reform. Lawmakers from both chambers will now have to determine which bill they will use as the vehicle for workers’ compensation reform. It is likely that the House and Senate will pass different versions of the reform bill and the differences will be worked out in a conference committee later this session.
“The major differences relate to how the system will be administered,” Woods said. “However, on the substance of the workers’ compensation law, the House and Senate are very close. We see both bills as being able to bring about positive reform and an important step in the right direction for getting control of a workers’ compensation system that has developed into a major problem for all participants.”
Was this article valuable?
Here are more articles you may enjoy.