Sec. 413.0112. REIMBURSEMENT OF FEDERAL MILITARY TREATMENT FACILITY. (a) In this section, "federal military treatment facility" means a medical facility that operates as part of the Military Health System of the United States Department of Defense.
(b) The reimbursement rates for medical services provided to an injured employee by a federal military treatment facility must be the amount charged by the facility as determined under 32 C.F.R. Part 220.
(c) Chapter 1305, Insurance Code, and the following sections of this code do not apply to the reimbursement of a federal military treatment facility's charges for medical services provided to an injured employee:
(1) Sections 408.027(a) and (f);
(2) Section 408.0271;
(3) Section 408.0272;
(4) Section 408.028;
(5) Section 408.0281;
(6) Section 413.011;
(7) Section 413.014;
(8) Section 413.031, as that section relates to medical fee disputes;
(9) Section 413.041; and
(10) Section 504.053.
(d) The commissioner shall adopt rules necessary to implement this section, including rules establishing:
(1) requirements for processing medical bills for services provided to an injured employee by a federal military treatment facility; and
(2) a separate medical dispute resolution process to resolve disputes over charges billed directly to an injured employee by a federal military treatment facility.
Added by Acts 2019, 86th Leg., R.S., Ch. 427 (S.B. 935), Sec. 1, eff. September 1, 2019.
Structure Texas Statutes
Title 5 - Workers' Compensation
Subtitle A - Texas Workers' Compensation Act
Subchapter B. Medical Services and Fees
Section 413.011. Reimbursement Policies and Guidelines; Treatment Guidelines and Protocols
Section 413.0111. Processing Agents
Section 413.0112. Reimbursement of Federal Military Treatment Facility
Section 413.0115. Requirements for Certain Voluntary or Informal Networks
Section 413.012. Medical Policy and Guideline Updates Required
Section 413.014. Preauthorization Requirements; Concurrent Review and Certification of Health Care
Section 413.0141. Initial Pharmaceutical Coverage
Section 413.015. Payment by Insurance Carriers; Audit and Review
Section 413.016. Payments in Violation of Medical Policies and Fee Guidelines
Section 413.017. Presumption of Reasonableness
Section 413.018. Review of Medical Care if Guidelines Exceeded
Section 413.019. Interest Earned for Delayed Payment, Refund, or Overpayment
Section 413.020. Division Charges
Section 413.021. Return-to-Work Coordination Services
Section 413.022. Return-to-Work Reimbursement Program for Employers; Fund
Section 413.023. Information to Employers