CHAPTER 405. WORKERS' COMPENSATION RESEARCH
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.