Texas UR - All Health Professionals must be TX licensed?! (T

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Texas UR - All Health Professionals must be TX licensed?! (T

Postby Ne1red on Mon May 13, 2013 10:48 am

Has anyone noticed that TEXAS changed the rule to require not only physicians but now nurses and other health care professionals also require a Texas license and that this change was only added to the workers comp UR rules in Rule 19.2006(a) and not the health UR Rule 19.1706(a) and not for specialty UR Rule 19.1716(e)(2)?

19.2006: http://info.sos.state.tx.us/pls/pub/readtac$ext.TacPage?sl=R&app=9&p_dir=&p_rloc=&p_tloc=&p_ploc=&pg=1&p_tac=&ti=28&pt=1&ch=19&rl=2006

19.1706: http://info.sos.state.tx.us/pls/pub/readtac$ext.TacPage?sl=R&app=9&p_dir=&p_rloc=&p_tloc=&p_ploc=&pg=1&p_tac=&ti=28&pt=1&ch=19&rl=1706

Rule 19.1716: http://info.sos.state.tx.us/pls/pub/readtac$ext.TacPage?sl=R&app=9&p_dir=&p_rloc=&p_tloc=&p_ploc=&pg=1&p_tac=&ti=28&pt=1&ch=19&rl=1716

This is absolutely inconsistent with the intent cited in the TDI Comments which specifically notes the following:

"Requiring all personnel performing UR of workers' comp services to be licensed in Texas or be otherwise authorized to provide health care services in Texas is consistent with the objectives of Labor Code section 408.023(h) and House Bill 1006, 80th Legislature...(Sept 1, 2007.)"

Even various sections of the comments and feedback from TDI (in the new 2013 UR rules) only reference physicians having Texas licensure. (e.g. Bottom of page 157 - notes a person should be licensed in the US and references TIC 4201.252 which does not address licensure - just qualifications, however the similar language in TIC 4201.455 specifically says licensure in the US. Comments on page 159-160 and TDI's reply is not consistent with the Labor Code and HB 1006 referenced specifically as these only mention physician licensure and NOT other healthcare professionals.

Utilization Review agents may conduct UR in all 50 states and for states to require nursing staff who will already be licensed in at least one US state is exceedingly burdensome, time consuming and serves no purpose in bettering the UR process or improving the safety or well being of patients (except perhaps to generate revenue in Texas.) UR Nurses do not provide hands on patient care and they are not denying treatment - only a physicians is able to deny medical treatment. (Nurses utilize the state mandated treatment guidelines to review proposed treatment and may approve but they cannot deny.)

The state also provided absolutely no time for UR nurses to obtain licensure in Texas if this was going to become a requirement. The state should have had a formal notification process directed to UR Agents with at least six months to a year advance notice. (A few years ago, when they added certification requirements for nurse case managers, they allowed up to two years.) It takes a great deal of time to become licensed in a state. While most states have a license endorsement process where a nurse can pay fees and complete the application/background check and the state validates all of the information and checks with other states where the nurse is licensed, Texas additionally requires a nurse to complete a jurisprudence exam. All of this takes time and cannot happen overnight. Additionally it creates a huge expense for UR companies for their nurses to get these licenses, continuing education and renewals.

When a recent Illinois memo suggested changes to the UR process, Work Comp Central and UR Agents, et al. were all over that, but I haven't seen a mention about the UR "health care personnel" now requiring TX licensure. Maybe no one noticed they added this section or everyone in workers comp UR has a TX license already?
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