Texas Labor Code - Section 402.075. Incentives; Performance-Based Oversight
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§ 402.075. INCENTIVES; PERFORMANCE-BASED
OVERSIGHT. (a) The commissioner by rule shall adopt requirements
that:
(1) provide incentives for overall compliance in the
workers' compensation system of this state; and
(2) emphasize performance-based oversight linked to
regulatory outcomes.
(b) The commissioner shall develop key regulatory goals to
be used in assessing the performance of insurance carriers and
health care providers. The goals adopted under this subsection
must align with the general regulatory goals of the division under
this subtitle, such as improving workplace safety and
return-to-work outcomes, in addition to goals that support timely
payment of benefits and increased communication.
(c) At least biennially, the division shall assess the
performance of insurance carriers and health care providers in
meeting the key regulatory goals. The division shall examine
overall compliance records and dispute resolution and complaint
resolution practices to identify insurance carriers and health care
providers who adversely impact the workers' compensation system and
who may require enhanced regulatory oversight. The division shall
conduct the assessment through analysis of data maintained by the
division and through self-reporting by insurance carriers and
health care providers.
(d) Based on the performance assessment, the division shall
develop regulatory tiers that distinguish among insurance carriers
and health care providers who are poor performers, who generally
are average performers, and who are consistently high performers.
The division shall focus its regulatory oversight on insurance
carriers and health care providers identified as poor performers.
(e) The commissioner by rule shall develop incentives
within each tier under Subsection (d) that promote greater overall
compliance and performance. The regulatory incentives may include
modified penalties, self-audits, or flexibility based on
performance.
(f) The division shall:
(1) ensure that high-performing entities are publicly
recognized; and
(2) allow those entities to use that designation as a
marketing tool.
(g) In conjunction with the division's accident prevention
services under Subchapter E, Chapter 411, the division shall
conduct audits of accident prevention services offered by insurance
carriers based on the comprehensive risk assessment. The division
shall periodically review those services, but may provide
incentives for less regulation of carriers based on performance.
Added by Acts 2005, 79th Leg., ch. 265, § 2.018, eff. Sept. 1,
2005.
Section: 402.068 402.069 402.070 402.071 402.072 402.073 402.074 402.075 402.076 402.077 402.078 402.081 402.082 402.083 402.084
Last modified: August 10, 2007
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