Senate Committee on Workers' Compensation, Select, Interim - 78th R.S. (2003)

Committee: Senate Workers' Compensation, Select, Interim
Title: Interim Report
Library Catalog Title: Report to the 79th Legislature
Subjects: Health care costs | Workers Compensation Commission, Texas | Workers' compensation |
Library Call Number: L1836.78 W892s
Session: 78th R.S. (2003)
Online version: View report [235 pages  File size: 1,581 kb]
Charges: This report should address the charges below.
1. Examine the status of the Health Care Network Advisory Committee's (HNAC) and the Texas Workers' Compensation Commission's implementation of the regional workers' compensation health care delivery networks outlined in Article 2 of HB 2600, 77th R.S. (2001).
2. Study the potential impact of networks on the workers' compensation health care delivery system. Include in the study: a. Quality of care; b. Network adequacy and access to care; c. Disclosure of information to patients, complaint procedures, appeal rights and overall patient satisfaction; d. Costs of care; e. Provider credentialing, selection and dispute resolution; f. Financial risks to providers, employers and carriers; g. Effects of networks on the Texas Workers' Compensation Commission; and h. Quality monitoring systems such as independent report cards.
3. Study the impact of the Texas Workers' Compensation Commission's 2002 Medical Fee Guideline on access to quality medical care for injured workers and medical costs, including recommendations on whether the legislature should statutorily prescribe a methodology for calculating the workers' compensation conversion factor.
4. Conduct a cost-benefit analysis, to the extent possible, comparing the Texas workers' compensation system to systems operating in other states. Make recommendations to improve the quality of care for injured workers, reduce fraud and inefficiencies, reduce overall claim costs, and streamline the administration of the system. Recommendations should address data exchange, advisory groups and review panels, dispute resolution, enforcement issues, paperwork reduction, and billing and administrative efficiencies.
5. Study the efficiency and effectiveness of the state's workers' compensation system including a comparison of the medical and indemnity costs associated with the Texas A&M University system, the Texas Department of Transportation and the State Office of Risk Management. Evaluate the potential costs and benefits associated with state agency participation in workers' compensation networks.
6. Survey the costs and benefits of other health system cost-containment strategies as they relate to medical, therapeutic, and pharmaceutical care, including but not limited to, doctor selection, deductibles, co-payments, preauthorization of services, and return-to-work programs.
7. Study and make recommendations relating to the pricing of workers' compensation insurance premiums in Texas, including, but not limited to, the impact of rating tools such as schedule rating, negotiated experience modifiers, negotiated deductibles and underwriting.

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