DWC Removes Pre-Auth for CARF WC and WH Services
Written by Editor   
Sunday, October 28, 2018 09:15 PM

On October 11, 2018, Commissioner of Workers' Compensation Cassie Brown adopted amendments to 28 Texas Administrative Code (TAC) §134.600, Preauthorization, Concurrent Utilization Review, and Voluntary Certification of Health Care A courtesy copy of the adoption is available on the Texas Department of Insurance website at www.tdi.texas.gov/wc/rules/2018rules.html.  The amendments remove references to the preauthorization exemption for Commission on Accreditation of Rehabilitation Facilities (CARF) accredited programs related to work conditioning (WC) and work hardening (WH) services. 

These amendments are in response to the amendment of Texas Labor Code §413.014, Preauthorization Requirements; Concurrent Review and Certification of Health Care, by Senate Bill 1494, 85th Legislature, Regular Session. As amended, Labor Code §413.014(c)(2) now requires preauthorization and concurrent review of all WC and WH services and grants the commissioner discretion to exempt from preauthorization and concurrent review WC and WH services “provided by a health care facility credentialed by an organization designated by commissioner rule.” These amendments exercise that discretion by notdesignating a credentialing organization for preauthorization exemption. 

Source:  https://www.tdi.texas.gov/wc/rules/adopted/documents/aocarf1018m.pdf