© Copyrighted 2008 by Downs Stanford, PC. All rights reserved. Reprinted with permission.

Stuart D. Colburn notes that the Division has published the adoption of the aforementioned rules [Rules 134.1, 134.2, 134.203, 134.204] which required one-hundred seventy-six pages to justify.  In essence, there are very little changes from the previous proposed rule and responses to the November public hearing.

The Division acknowledges reimbursements for professional services (other than surgery) will increase $51 million or 9.8% and surgical reimbursements will increase $20.6 million or 39.5% for a total increase of $71.6 million and a 7.2% increase.  The Division notes their estimates are consistent with NCCI data which calculates a 7.1% increase.

The Division believes the Disability Management Rules will assist containing these cost projections.  Therefore, the Division admits employers and carriers will not experience any real cost savings from disability management.  The Division increases medical reimbursements to doctors in hopes of increasing the access to medical care without increasing overall medical costs to employers and carriers.  Therefore, Texas will probably retain its current high ranking in average medical costs per claim as compared to other states.

The new reimbursement rules and procedures went into effect March 1, 2008 with updates beginning January 1 of each calendar year.

To read Colburn's additional comments and practice points on this topic, see his expert commentary article.