CHAPTER 405. WORKERS' COMPENSATION RESEARCH - Texas Statutes

LABOR CODE

TITLE 5. WORKERS' COMPENSATION

SUBTITLE A. TEXAS WORKERS' COMPENSATION ACT

CHAPTER 405. WORKERS' COMPENSATION RESEARCH

Sec. 405.001. DEFINITION. In this chapter, "group" means the

workers' compensation research and evaluation group.

Added by Acts 2003, 78th Leg., 3rd C.S., ch. 10, Sec. 1.01, eff.

Oct. 20, 2003.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.018, eff. September 1, 2005.

Sec. 405.002. WORKERS' COMPENSATION RESEARCH DUTIES OF

DEPARTMENT. (a) The workers' compensation research and

evaluation group is located within the department and serves as a

resource for the commissioner of insurance on workers'

compensation issues.

(b) The department may apply for and spend grant funds to

implement this chapter.

(c) The department shall ensure that all research reports

prepared under this chapter or by the former Research and

Oversight Council on Workers' Compensation are accessible to the

public through the Internet to the extent practicable.

Added by Acts 2003, 78th Leg., 3rd C.S., ch. 10, Sec. 1.01, eff.

Oct. 20, 2003.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.019, eff. September 1, 2005.

Sec. 405.0025. RESEARCH DUTIES OF GROUP. (a) The group shall

conduct professional studies and research related to:

(1) the delivery of benefits;

(2) litigation and controversy related to workers' compensation;

(3) insurance rates and ratemaking procedures;

(4) rehabilitation and reemployment of injured employees;

(5) the quality and cost of medical benefits;

(6) employer participation in the workers' compensation system;

(7) employment health and safety issues; and

(8) other matters relevant to the cost, quality, and operational

effectiveness of the workers' compensation system.

(b) The group shall:

(1) objectively evaluate the impact of the workers' compensation

health care networks certified under Chapter 1305, Insurance

Code, on the cost and the quality of medical care provided to

injured employees; and

(2) report the group's findings to the governor, the lieutenant

governor, the speaker of the house of representatives, and the

members of the legislature not later than December 1 of each

even-numbered year.

(c) At a minimum, the report required under Subsection (b) must

evaluate the impact of workers' compensation health care networks

on:

(1) the average medical and indemnity cost per claim;

(2) access and utilization of health care;

(3) injured employee return-to-work outcomes;

(4) injured employee satisfaction;

(5) injured employee health-related functional outcomes;

(6) the frequency, duration, and outcome of complaints; and

(7) the frequency, duration, and outcome of disputes regarding

medical benefits.

Added by Acts 2005, 79th Leg., Ch.

265, Sec. 3.020, eff. September 1, 2005.

Sec. 405.0026. RESEARCH AGENDA. (a) The group shall prepare

and publish annually in the Texas Register a proposed workers'

compensation research agenda for the commissioner of insurance

review and approval.

(b) The commissioner of insurance shall:

(1) accept public comments on the research agenda; and

(2) hold a public hearing on the proposed research agenda if a

hearing is requested by interested persons.

Added by Acts 2005, 79th Leg., Ch.

265, Sec. 3.020, eff. September 1, 2005.

Sec. 405.003. FUNDING; MAINTENANCE TAX. (a) The group's duties

under this chapter are funded through the assessment of a

maintenance tax collected annually from all insurance carriers,

and self-insurance groups that hold certificates of approval

under Chapter 407A, except governmental entities.

(b) The department shall set the rate of the maintenance tax

based on the expenditures authorized and the receipts anticipated

in legislative appropriations. The tax rate for insurance

companies may not exceed one-tenth of one percent of the

correctly reported gross workers' compensation insurance

premiums. The tax rate for certified self-insurers may not exceed

one-tenth of one percent of the total tax base of all certified

self-insurers, as computed under Section 407.103(b). The tax rate

for self-insurance groups described by Subsection (a) may not

exceed one-tenth of one percent of the group's gross premium for

the group's retention, excluding premium collected by the group

for excess insurance.

(c) The tax imposed under Subsection (a) is in addition to all

other taxes imposed on those insurance carriers for workers'

compensation purposes.

(d) The tax on insurance companies and on self-insurance groups

described by Subsection (a) shall be assessed, collected, and

paid in the same manner and at the same time as the maintenance

tax established for the support of the department under Chapter

255, Insurance Code. The tax on certified self-insurers shall be

assessed, collected, and paid in the same manner and at the same

time as the self-insurer maintenance tax collected under Section

407.104.

(e) Amounts received under this section shall be deposited in

the general revenue fund in accordance with Section 251.004,

Insurance Code, to be used:

(1) for the operation of the group's duties under this chapter;

and

(2) to reimburse the general revenue fund in accordance with

Section 201.052, Insurance Code.

(f) Section 403.095, Government Code, does not apply in relation

to amounts received under this section or to any special account

into which the amounts are deposited.

Added by Acts 2003, 78th Leg., 3rd C.S., ch. 10, Sec. 1.01, eff.

Oct. 20, 2003.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.021, eff. September 1, 2005.

Acts 2005, 79th Leg., Ch.

728, Sec. 11.136, eff. September 1, 2005.

Sec. 405.004. COORDINATION WITH OTHER STATE AGENCIES;

CONFIDENTIALITY. (a) As required to fulfill the group's

objectives under this chapter, the group is entitled to access to

the files and records of:

(1) the division;

(2) the Texas Workforce Commission;

(3) the Department of Assistive and Rehabilitative Services;

(4) the office of injured employee counsel;

(5) the State Office of Risk Management; and

(6) other appropriate state agencies.

(b) A state agency shall assist and cooperate in providing

information to the group.

(c) Information that is confidential under state law is

accessible to the department under rules of confidentiality and

remains confidential.

(d) Except as provided by this subsection, the identity of an

individual or entity selected to participate in a survey

conducted by the group or who participates in such a survey is

confidential and is not subject to public disclosure under

Chapter 552, Government Code. This subsection does not prohibit

the identification of a workers' compensation health care network

in a report card issued under Section 1305.502, Insurance Code,

provided that the report card may not identify any injured

employee or other individual.

(e) A working paper, including all documentary or other

information, prepared or maintained by the group in performing

the group's duties under this chapter or other law to conduct an

evaluation and prepare a report is excepted from the public

disclosure requirements of Section 552.021, Government Code.

(f) A record held by another entity that is considered to be

confidential by law and that the group receives in connection

with the performance of the group's functions under this chapter

or another law remains confidential and is excepted from the

public disclosure requirements of Section 552.021, Government

Code.

(g) The commissioner of insurance shall adopt rules as necessary

to establish data reporting requirements to support the research

duties under this chapter. This section may not be construed as

requiring additional reporting requirements on nonsubscribing

employers.

Added by Acts 2003, 78th Leg., 3rd C.S., ch. 10, Sec. 1.01, eff.

Oct. 20, 2003.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.022, eff. September 1, 2005.