Texas Administrative Code
Title 28 - INSURANCE
Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION
Chapter 42 - MEDICAL BENEFITS
Subchapter A - GENERAL MEDICAL PROVISIONS
Section 42.75 - Excess Recovery from Third Party Actions

Universal Citation: 28 TX Admin Code ยง 42.75

Current through Reg. 49, No. 38; September 20, 2024

(a) When an injured worker has received an excess recovery in a third party action, pursuant to Texas Civil Statutes, Article 8307, §6a(c), the carrier shall immediately:

(1) notify all providers of the date of the judgment or agreed judgment, and the amount of the excess; and

(2) file a copy of the judgment or agreed judgment with the board.

(b) The provider shall continue to submit reports as required by these sections.

(c) Bills for services and supplies provided after the judgment date shall be sent to the injured worker, or his or her representative. Copies of such bills shall be filed with the carrier.

(d) The claimant shall notify the board, the carrier, and current health care providers when the amount of the excess has been reduced to zero. Upon receipt of such notice, the provider(s) shall resume billing only the carrier, pursuant to § 42.30 of this title (relating to Written Communications).

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