Texas Register, Volume 28, Number 14, Pages 2821-2988, April 4, 2003 Page: 2,883
2821-2988 p. ; 28 cm.View a full description of this periodical.
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401.011(27)) or the third party representing the insurance
carrier for various claim administration functions such as
coverage confirmation, claim adjustment, medical billing and
preauthorization. The commission is continuously asked for this
contact information but does not currently collect or maintain it
in a standardized or accessible form. The commission proposes
to add 124.2(n) to require each insurance carrier to create and
maintain a single World Wide Web (Web) page containing this
information and to furnish the Uniform Resource Locator (URL)
of that Web page to the commission through its Austin repre-
sentative. The commission will then make that URL available to
the public and the commission staff through its Web site.
The Texas Register published text shows words proposed to be
added to or deleted from the current text, and should be read to
determine all proposed changes.
Proposed subsection 124.2(c)(1) requires that certain coverage
information (insurance carrier FEIN, policy number and policy
period) be reported by the insurance carrier in conjunction with
the information from the Employer's First Report of Injury and
that this information be identical with that reported under 110.1
for the employer associated with the claim.
Proposed subsection 124.2(c)(4) requires that the coverage
information required by subsection 124.2(c)(1) be reported
through a Change transaction if it is not available when the First
Report of Injury is submitted to the commission.
Proposed new subsection 124.2(n) is added to state the require-
ment for each insurance carrier to create and maintain a Web
page containing contact information for the claim service func-
tions of coverage verification, claim adjustment, medical billing,
pharmacy billing if different from medical billing, and preautho-
rization request processing. The organization and presentation
of this information should reflect the insurance carrier's business
organization and may be done geographically, functionally, by
specific insured, or a combination of these. Telephone and fac-
simile numbers, mailing address, and company and/or depart-
ment email address information for each function shall be pro-
vided. It is anticipated that an insurance carrier's Austin repre-
sentative will provide the URL for its Web page to the commission
through its access to the commission's automation system (TX-
COMP) for the purpose of inputting and maintaining the carrier's
correct URL.
Brent Hatch, Director of Customer Relations and Customer Ser-
vices, has determined that for the first five-year period the pro-
posed rule is in effect there will be minimal fiscal implications
for state or local governments as a result of enforcing or ad-
ministering the proposed rule because it does not impose ad-
ditional duties for these entities. Self-insured governmental enti-
ties could incur some nominal costs associated with procedural
changes required to ensure consistency of information reported
between coverage reporting under 110.1 and claim reporting
under 124.2 as proposed. They may also incur nominal costs
associated with development of the required Web page if it can-
not be accommodated within the routine maintenance and up-
dating of their Web site.
Local government and state government as a covered regulated
entity will be impacted in the same manner as described later
in this preamble for persons required to comply with the rule as
proposed.
Mr. Hatch has also determined that for each year of the first
five years the rule as proposed is in effect the public benefits
anticipated as a result of enforcing the rule will be as follows:The public will benefit from the proposed change in that the com-
mission will be able to more quickly, accurately and efficiently as-
sociate a reported workers' compensation claim with the related
coverage information and therefore more accurately advise the
parties to the claim on status and actions relating to the claim.
The commission will also be able to provide to the public, work-
ers' compensation system participants, and to the commission
staff access to the contact information for the insurance carrier's
various claim administration functions in a comprehensive and
easily accessible manner.
There may be some economic costs to persons who are required
to comply with the rule as proposed. Both the Coverage and
Claim reporting channels are already established and are not
changed by this proposal. However, procedural changes may be
required, depending on the regulated entity's current practices.
Should a regulated entity elect to modify its automation systems
in order to facilitate compliance with the proposed rules, then
significant economic costs could be incurred. The only new re-
quirement is consistency of reporting between the two reporting
channels.
Persons who are required to comply with the rule as proposed
may also incur nominal costs associated with development of
the required Web page if it cannot be accommodated within the
routine maintenance and updating of their current Web site. The
required Web page is a simple, static, content only page with no
functionality required. It can be developed and hosted using the
most basic of Web technology and can be either a component
of an existing Web site or a single page hosted on an Internet
accessible server.
There will be no different costs of compliance for small busi-
nesses or micro-businesses as compared to large businesses.
There will be no adverse economic impact on small businesses
or micro-businesses.
Comments on the proposal or requests for public hearing must
be received by 5:00 p.m., May 5, 2003. You may comment
via the Internet by accessing the commission's website at
www.twcc.state.tx.us, clicking on "Laws, Rules & Forms" and
then clicking on "Proposed Rules." This medium for commenting
will help you organize your comments by rule chapter. You may
also comment by emailing your comments to RuleComments@
twcc.state.tx.us or by mailing or delivering your comments to
Nell Cheslock, Legal Services, Mailstop #4-D, Texas Workers'
Compensation Commission, Southfield Building, 4000 South
IH-35, Austin, Texas 78704-7491.
Commenters are requested to clearly identify by number the spe-
cific rule and paragraph commented upon. The commission may
not be able to respond to comments that cannot be linked to a
particular proposed rule. Along with your comment, it is sug-
gested that you include the reasoning for the comment in order
for commission staff to fully evaluate your recommendations.
Commenters are also requested to provide the commission with
any concerns or suggestions regarding the information required
by new subsection (n) of the rule as proposed, particularly the
types of contact information specified in subsection (n)(1) and
whether the rule should require any additional information or,
perhaps, less information.
Based upon various considerations, including comments
received and the staff's or commissioners' review of those
comments, or based upon the commissioners' action at the
public meeting, the rule as adopted may be revised from the
rule as proposed in whole or in part. Persons in support of thePROPOSED RULES April 4, 2003 28 TexReg 2883
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Texas. Secretary of State. Texas Register, Volume 28, Number 14, Pages 2821-2988, April 4, 2003, periodical, April 4, 2003; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth101027/m1/62/: accessed May 26, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.