408.0251
(a) The commissioner, by rule and in cooperation with the commissioner of insurance, shall adopt rules regarding the electronic submission and processing of medical bills by health care providers to insurance carriers. (b) Insurance carriers shall accept medical bills submitted electronically by health care providers in accordance with commissioner rule. (c) The commissioner shall by […]
408.0252
The commissioner by rule may identify areas of this state in which access to health care providers is less available and may adopt appropriate standards, guidelines, and rules regarding the delivery of health care in those areas. Added by Acts 2005, 79th Leg., ch. 265, § 3.087, eff. Sept. 1, 2005.
408.026
Except in a medical emergency, an insurance carrier is liable for medical costs related to spinal surgery only as provided by Section 413.014 and commissioner rules. Acts 1993, 73rd Leg., ch. 269, § 1, eff. Sept. 1, 1993. Amended by Acts 2001, 77th Leg., ch. 1456, § 4.01, eff. June 17, 2001; Acts 2005, 79th […]
408.0271
(a) If the health care services provided to an injured employee are determined by the insurance carrier to be inappropriate, the insurance carrier shall: (1) notify the health care provider in writing of the carrier’s decision; and (2) demand a refund by the health care provider of the portion of payment on the claim that […]
408.031
(a) Notwithstanding any other provision of this chapter, an injured employee may receive benefits under a workers’ compensation health care network established under Chapter 1305, Insurance Code, in the manner provided by that chapter. (b) In the event of a conflict between this title and Chapter 1305, Insurance Code, as to the provision of medical […]
408.041
(a) Except as otherwise provided by this subtitle, the average weekly wage of an employee who has worked for the employer for at least the 13 consecutive weeks immediately preceding an injury is computed by dividing the sum of the wages paid in the 13 consecutive weeks immediately preceding the date of the injury by […]
408.043
(a) For determining the amount of temporary income benefits of a seasonal employee, the average weekly wage of the employee is computed as provided by Section 408.041 and is adjusted as often as necessary to reflect the wages the employee could reasonably have expected to earn during the period that temporary income benefits are paid. […]
408.0446
(a) For determining the amount of temporary income benefits of a school district employee under Chapter 504, the average weekly wage is computed on the basis of wages earned in a week rather than on the basis of wages paid in a week. The wages earned in any given week are equal to the amount […]
408.045
The division may not include nonpecuniary wages in computing an employee’s average weekly wage during a period in which the employer continues to provide the nonpecuniary wages. Acts 1993, 73rd Leg., ch. 269, § 1, eff. Sept. 1, 1993. Amended by Acts 2005, 79th Leg., ch. 265, § 3.099, eff. Sept. 1, 2005.
408.047
(a) On and after October 1, 2006, the state average weekly wage is equal to 88 percent of the average weekly wage in covered employment computed by the Texas Workforce Commission under Section 207.002(c). (b) Expired. (c) Notwithstanding Subsection (a), the commissioner by rule may increase the state average weekly wage to an amount not […]