UR Nation Salutes TDI for their Rapid Response to Hurricane Harvey

| | Physician Peer Review, Utilization Review

Jaelene Article Oct 2017 Hurricane Harvey
Hurricane Harvey proved to be an extremely deadly and destructive hurricane. Upon entering the Caribbean Sea on August 17, Harvey began to weaken. At this point many watching Harvey thought it was much ado about nothing. But then on August 23 Harvey redeveloped over the Bay of Campeche. That same day Governor Greg Abbot declared a state of emergency for 30 Texas counties. By the end of August 24 it was again a hurricane.

As it moved northwest toward the Texas coast, Harvey gained even more strength and became a Category 4 Hurricane with 130 to 150 mile an hour winds. This is roughly the same intensity as the 1900 Galveston hurricane, which is still the deadliest natural disaster to hit the United States. On August 25-26 Harvey made landfall and devastated the city of Rockport, then churned along the coast dropping unprecedented amounts of rainfall over Southern and East Texas. Governor Abbot added an additional 20 counties to the state of emergency. In all, Harvey caused at least 84 confirmed deaths and widespread damage preliminarily estimated between $70 and $200 billion dollars.

A few days after Harvey hit Rockport, the Texas Department of insurance (TDI) issued a Commissioner’s Bulletin for all workers’ comp system participants. In the bulletin, Commissioner Ryan Brannon set forth that for claims residing in a county included in Governor Abbot’s disaster proclamation all system participants were to do the following:

  • Provide benefit checks and necessary medical care, services, and supplies
  • Waive penalties and restrictions related to emergency and non-emergency care provided out-of-network
  • Provide coverage for payment for necessary emergency and non-emergency health care services obtained out-of-network
  • Extend deadlines for medical examinations
  • Authorize payment to pharmacies for up to 90 days for individuals regardless of the date upon which the prescription had most recently been filled
  • Expedite change of address processing

Furthermore, Commissioner Brannon has stated that deadlines need to be extended for the following actions for the duration of Governor Abbott’s disaster proclamation:

  • Workers’ compensation claim notification and filing
  • Medical billing
  • Medical and income benefit payments,
  • Electronic data reporting
  • Medical and income disputes

The bulletin referenced Texas Government Code §418.017 which states that all necessary measures, both public and private, be utilized to meet the threat. For those interested, you can see that this code section is part of the Texas Emergency Management Statues.

At UR Nation, we were relieved to see Commissioner Brannon’s bulletin, on many levels. First, it showed that Commissioner Brannon’s office was closely tracking Hurricane Harvey and the destruction it had caused. Next, it gave all system participants immediate common sense direction. In other words, if an injured worker needed to respond to a workers’ comp deadline by a specific date, but his or her house had been badly damaged by wind or flooding, the injured worker would not be penalized as if he was refusing to comply. Also, it helped insurance carriers and utilization review agents know that deadlines were to be relaxed. So if a provider could not get needed information to the URA in time to meet the three working day requirement for prospective review, all parties involved would be allowed additional time. The bulletin was a clear, common sense message provided quickly after disaster struck.

While many people may believe that Commissioner Brannon was just “doing his job” in producing the bulletin in a timely manner, as system participants we found ourselves very thankful. Great job Commissioner Brannon!

Jaelene Fayhee

Jaelene Fayhee

Jaelene Fayhee, AVP, Client Solutions for UniMed Direct, is a regulatory expert who works hand-in-hand with clients and the technology department to deliver technology and medical solutions to clients. Jaelene is focused on using technology to ensure compliance with current and upcoming regulatory requirements and delivering prompt and appropriate decisions to expedite medical decisions for injured workers.