HBA-MSH H.B. 1192 77(R)    BILL ANALYSIS


Office of House Bill AnalysisH.B. 1192
By: Brimer
Business & Industry
2/19/2001
Introduced



BACKGROUND AND PURPOSE 

Current law entitles state employees to receive medical benefits for
injuries sustained while on the job. Except in an emergency, employees are
required to seek medical treatment from a list of doctors approved by the
Texas Workers' Compensation Commission (TWCC).  The list includes each
doctor licensed in this state on January 1, 1993, except those who have
been removed by TWCC from the lists for certain questionable practices.
House Bill 1192 creates a pilot program that contracts with a network of
doctors, known as gateway physicians, to provide medical treatment to
injured state employees to evaluate the effectiveness of the use of gateway
physicians in reducing costs incurred by the state and in providing better
treatment to injured workers.   

RULEMAKING AUTHORITY

It is the opinion of the Office of House Bill Analysis that rulemaking
authority is expressly delegated to the risk management board and the board
of directors of the Research and Oversight Council on Workers' Compensation
in SECTION 1 (Section 412.065, Labor Code) and SECTION 4 of this bill. 

ANALYSIS

House Bill 1192 amends the Labor Code to require the State Office of Risk
Management (office) and the Research and Oversight Council on Workers'
Compensation (council) to jointly develop and implement a pilot program
(program) to provide medical benefits to certain state employees who
sustain compensable injuries through the use of a health care delivery
network under which health care is provided by specific health care
practitioners under contract (gateway physician).  The bill requires the
office and the council to jointly select a limited number of state agencies
to participate in the program and provides that the selected agencies are
required to participate.  The bill requires the office and the council to
design the program in a manner that enhances the delivery of medical
benefits by providing better health care and faster access to that care,
and enables the state to determine whether extension of the use of a health
care delivery network and gateway physicians would decrease direct costs
associated with the operation of the state employee workers' compensation
program. 

The bill requires the office and the council to submit a written report to
the legislature concerning the effectiveness of the program in reducing
state medical benefits costs no later than February 1 of each oddnumbered
year.  The bill authorizes the risk management board (board) and the board
of directors of the council to adopt rules and enter into contracts as
necessary or appropriate to implement the program not later than December
1, 2001.  The bill exempts employees participating in the program from
provisions requiring them to receive medical treatment, as it relates to
workers' compensation benefits, from a doctor chosen from a list of doctors
approved by the Texas Workers' Compensation Commission. 

The bill provides that employees of agencies participating in the program
are required to use the  services of a gateway physician or specialist
participating in the program to receive medical benefits.  The bill
entitles an employee to select an initial treating doctor from the list of
gateway physicians.  The bill requires the board to provide employees of
participating agencies with a list of participating gateway physicians or
specialists. 
 
EFFECTIVE DATE

September 1, 2001, and applies only to a claim for workers' compensation
benefits based on a compensable injury that occurs on or after January 1,
2002.