DWC Adopts Death Benefits Rule; Plans Changes to UR and Peer Credentialing Rule
The Division of Workers’ Compensation is still engaged in rulemaking as a result of the 2019 legislative session. The agency has adopted one rule in response to legislative changes in death benefits eligibility and is making plans to revise the rule that describes the credentials a physician who performs a peer review, utilization review, or independent review of health care services provided to an injured employee must possess.
Eligibility of Certain Spouses to Receive Death Benefits
HB 2503 expanded eligibility of spouses who may receive death benefits for life, regardless of remarriage, to spouses of peace officers as described in Texas Code of Criminal Procedures Article 2.12 and intrastate fire mutual aid system team members or regional incident management team members. HB 2503 only applies to an eligible spouse who remarries on or after September 1, 2019.
The Division has adopted an amendment to 28 Texas Administrative Code §132.7 to conform to Texas Labor Code §408.183. Effective September 1, 2019, the Legislature amended Labor Code §408.183 under House Bill (HB) 2503. On September 1, 2020, the Division’s adopted changes will align DWC’s rules on the duration of death benefits with the statutory changes made by HB 2503.
The adopted rules were published in the September 4, 2020, issue of the Texas Register and are available at http://www.sos.state.tx.us/texreg/index.shtml. The Division has also posted the adopted rule on its website.
UR and Peer Review Credentialing
Senate Bill 1742 amended Labor Code §408.0043, Professional Specialty Certification Required for Certain Review, to require that a physician who performs a peer review, utilization review, or independent review of health care services provided to an injured employee must be of the same or similar specialty as the physician requesting, ordering, or providing the service being reviewed. The amendment requires rulemaking.
Accordingly, the Division has announced plans to revise the definition of “appropriate credentials” in 28 Texas Administrative Code §180.1(4) to conform the language regarding the credentials of reviewing physicians with the changes made to Labor Code §408.0043 by SB 1742. The informal rule text is available on the TDI website at www.tdi.texas.gov/wc/rules/drafts.html.
The agency will host a virtual stakeholder meeting on October 7, 2020, at 1:30 p.m., Central time, through Zoom to discuss the proposed change to the definition of appropriate credentials in 28 TAC §180.1. Information on how to connect to the meeting will be available on the TDI website. System stakeholders mail their comments to RuleComments@tdi.texas.gov. Comments may also be mailed or delivered to:
Cynthia Guillen
Legal Services, MS-4D
Texas Department of Insurance, Division of Workers’ Compensation
7551 Metro Center Drive, Suite 100
Austin, Texas 78744-1645
The Division must receive all written comments by 5 p.m., Central time, on Friday, October 16, 2020.
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