DWC Proposes Rules to Implement Federal Military Treatment Facility Bill Processing

Last session, the legislature passed SB 935 by Sen. Hancock, which concerns the obligation of a workers’ compensation carrier to pay bills from medical facilities that operate as part of the Military Health System of the United States Department of Defense. One example is Brooke Army Medical Center.

The Division is required to pass rules to implement the changes made in the legislation. Those rules must include requirements for processing medical bills for services provided to an injured employee by a federal military treatment facility; and a separate medical dispute resolution process to resolve disputes over charges billed directly to an injured employee by a federal military treatment facility.

The Division has published proposed rules to implement the legislation. Proposed §134.150 describes procedures for reimbursing medical bills for services provided by a federal military treatment facility. Proposed §134.155 provides a medical dispute resolution process regarding services provided by a federal military treatment facility.

The proposed rules were published in the August 30, 2019, issue of the Texas Register and are available at www.sos.state.tx.us/texreg/index.shtml. A courtesy copy is also available on the DWC website at www.tdi.texas.gov/wc/rules/2019rules.html.

The Division is accepting public comments on proposed new rules for 28 Texas Administrative Code §134.150 and §134.155 to implement the legislation.

In addition, DWC will host a public hearing on these rules on Monday, September 16, 2019, at 10 a.m. at the DWC central office located at 7551 Metro Center Drive, Suite 100, in Austin. Written comments on the proposed rules may be submitted at the meeting, by email to RuleComments@tdi.texas.gov, or by mailing or delivering your comments to:

Cynthia Guillen
Office of General Counsel, MS-4D
Texas Department of Insurance, Division of Workers’ Compensation
7551 Metro Center Drive, Suite 100, Austin, Texas 78744-1645

To be considered, comments must be received by 5 p.m., Central time, on Monday, September 30, 2019

CSSB 935 was signed by the Governor June 4, 2019 and took effect September 1, 2019. The bill states that the new provision applies only to health care services provided on or after January 1, 2020, in conjunction with a claim for workers ’ compensation benefits, regardless of the date on which the compensable injury that is the basis of the claim occurred.