Texas Workers' Compensation

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§ 133.280. Employer Reimbursement for Health Care Paid

(a) An employer may request reimbursement from the insurance carrier when the employer has paid for health care provided for a compensable injury, and provided notice of injury in compliance with Labor Code § 409.005.

(b) The employer shall be reimbursed in accordance with § 134.1.

(c) The employer may seek reimbursement for any payment made above the Division fee guideline or contract amount from the health care provider who received the overpayment.

(d) The employer’s request for reimbursement shall be legible and shall include:

(1) a copy of the health care provider’s required billing form;

(2) any supporting documentation submitted by the health care provider as required in § 133.210 of this chapter (relating to Medical Documentation); and

(3) documentation of the payment to the health care provider.

(e) The insurance carrier shall submit employer medical bill and payment data to the Division in accordance with § 134.802 of this title (relating to Insurance Carrier Medical Electronic Data Interchange to the Division).

The provisions of this § 133.280 adopted to be effective May 2, 2006, 31 TexReg 3544.

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At a Glance:

Title:

§ 133.280. Employer Reimbursement for Health Care Paid

Title:

Title 28. Insurance

Status:

Current

Usage:

New Law Rule

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