Brief⁽¹⁾

H.B. 2799 amends the Workers Compensation Act to provide the following:

• Allow allocated loss adjustment expenses, which may include legal and medical expenses incurred in defense of the claim, expert witness fees, arbitration fees, copying charges, utilization review expenses, and appeals fees, to be included with optional deductibles that insurers may offer in workers compensation insurance policies.



• Allow the admissibility of utilization and peer review reports at preliminary hearings.



• Allow for the conservatorship of certain minors entitled to workers compensation to be in accord with the Probate Code.



• Allow for video conferencing in a mediation conference.



• Expand the list of criminal behavior to include a person who receives unentitled temporary total disability benefits or unentitled permanent total disability benefits while employed. Also included is a person who conspires with another to commit the above described acts.

• Penalties for the illegal acts described above would be expanded as follows:

• a severity level 7, nonperson felony, if the amount received as a benefit or payment is more than $25,000 but less than $50,000;



• a severity level 6, nonperson felony if the amount received is more than $50,000 but less than $100,000; or



• a severity level 5, nonperson felony if the amount received is more than $100,000.

Other criminal penalties to be included are as follows:

• Any person who knowingly and intentionally presents a false certificate of insurance shall be guilty of a level 8, nonperson felony.



• A health care provider who knowingly and intentionally submits a charge for health care that was not furnished, shall be guilty of a level 9, nonperson felony.



• Any person who obtains or attempts to obtain a more favorable workers compensation insurance premium rate than that to which the person is entitled, who prevents, reduces, avoids, or attempts to prevent, reduce, or avoid the payment of any compensation or who fails to communicate a settlement offer or similar information to a claimant under the Workers Compensation Act by, in any such case knowingly or intentionally:

• making a false or misleading statement;



• misrepresenting or concealing a material fact;



• fabricating, concealing, or destroying a document; or



• conspiring with another person or persons to commit these illegal acts shall be guilty of a level 9, nonperson felony.

• Provide immunity for a person who refers a possible fraudulent or abusive act when the referral is made in good faith.

Background

A conferee representing the American Insurance Association spoke in favor of the bill.

The fiscal note indicates no long-range fiscal effect.

Certain Senate Committee amendments were similar to provisions contained in S.B. 555.

1. *Supplemental notes are prepared by the Legislative Research Department and do not express legislative intent. The supplemental note and fiscal note for this bill may be accessed on the Internet at http://www.ink.org/public/legislative/fulltext-bill.html.