House Bill 7

• Creation of workers' compensation networks. Networks will improve outcomes and lower the cost of claims by focusing on evidence-based care and return-to-work, minimizing arguments over medical necessity that plague the current system, and through market-based competition. Any entity may seek certification through the Texas Department of Insurance (TDI) to serve as a workers' compensation health care network. Certified networks would contract with insurance carriers or self-insured employers. Where contracts are in place, injured employees would choose their doctor from within the network. In addition, network providers would be subject to greater surety of payment in claims where the work-relatedness of an injury is in question, and insurance carriers would be required to pay the cost of in-network medical disputes.
• Enhanced benefits for injured employees. Injured employees will wait half as long to receive compensation for their first week of lost pay, and will see the cap on weekly income benefits rise by about 15 percent - from well below to slightly more than the national median. HB 7 represents the first significant enhancements in income benefits for injured employees in more than 15 years.
• State agency oversight. HB 7 replaces the ineffective Texas Workers' Compensation Commission with a Division of TDI headed by a Governor-appointed commissioner. This ensures proper focus on workers' compensation issues but also allows integration of the workers' compensation system into TDI's regulatory structure and expertise.
• Creation of the Office of Injured Employee Counsel (OIEC). For the first time, the state will have a dedicated agency with the sole focus of helping injured employees. The OIEC will oversee the ombudsman program and advocate for the interests of injured employees on key rules and policies, to ensure balance and fairness for all in the system.
• Renewed focus on return-to-work. Return-to-work was never among the highest priorities of the TWCC. It will always remain one of the highest priorities of TDI, through the new division. Both the implementation of evidence-based guidelines that will encourage a focus on return-to-work and the implementation of networks will bring improvements. Specific provisions in the bill also require TDI to work more closely with other state agencies that provide assistance to those in need of new job skills, and establish a pilot program offering cash grants to small employers who bring injured employees back into the workforce.
• Insurance rate and premium oversight. HB 7 provides broad new authority to TDI to impose sanctions on carriers who do not pass on savings to employers in the form of lower premiums.