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After a report conducted by the Workers’ Compensation Research and Evaluation Group concluded there was no statistical difference in disability duration between CARF-accredited and non CARF-accredited programs, the Division has proposed amendments to Division Rules 134.600 (regarding preauthorization, concurrent utilization review, and voluntary certification of health care) to remove the exemption status from CARF-accredited facilities. The Division is also proposing to amend Rule 134.230 (regarding return to work rehabilitation programs) to set one fee schedule for work hardening and work conditioning services, regardless of a facility’s accreditation status, by removing the increased payment to CARF-accredited facilities providing these services.
The proposed amendments are additionally intended to implement Senate Bill 1494 of the 85th Legislative Regular Session, which amended Texas Labor Code Section 413.014 to require preauthorization and concurrent utilization review for health care facilities providing work-hardening (WH) or work-conditioning (WC) programs. Currently, health care facilities that are accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF) are exempt from preauthorization and concurrent review requirements for WH and WC. The bill no longer requires, but instead permits, the commissioner, by rule, to exempt a credentialed health care facility providing WH and WC services from preauthorization and concurrent review requirements.
The Division is accepting comments for the amendments. The informal working draft is available atwww.tdi.texas.gov/wc/rules/drafts.html. The comment period closes on February 2, 2018 at 5:00 p.m.
~ This blog submission was prepared by Erin Shanley, an attorney with Stone Loughlin & Swanson, LLC, a law firm dedicated to representing self-insured employers, insurance carriers, and third party administrators in all matters related to workers’ compensation. Stone Loughlin & Swanson is a member of the National Workers’ Compensation Defense Network (NWCDN). If you have any questions about this submission or Texas workers’ compensation in general, please contact Erin by e-mailing her at email@example.com or by calling her directly at (512) 343-1300.