On February 3, 2011 the Commissioner of Workers’ Compensation Rod Bordelon adopted amendments to 28 Texas Administrative Code (TAC) §§133.10, 133.500, and 133.501 and adopted new §133.502 regarding medical bill processing. The adoption was filed with the Office of the Secretary of State on February 7, 2011 for publication and the final version will be published in the February 18, 2011 issue of the Texas Register. The adoption may currently be viewed on the Texas Department of Insurance (TDI) website at: www.tdi.state.tx.us/wc/rules/adopted/index.html.
The purpose of the adoptions is to add necessary requirements to ensure that workers’ compensation medical billing aligns, to the extent possible, with the billing requirements and standards adopted by the Centers for Medicare and Medicaid Services (CMS) as required by Texas Labor Code §413.011. The amendments and additions clarify the data standards, requirements and processes associated with electronic medical bill processing as required by Texas Labor Code §408.0251. Additionally, these rules clarify the field requirements for paper medical bills submitted by health care providers who are exempt from electronic submission.
The DWC Form-066, Statement of Pharmacy Services, is being revised to conform with the adopted rules. The finalized form will be made available to workers’ system participants at a later date. The adopted rules are effective August 1, 2011.