Tex. Labor Code Section 413.042
Private Claims; Administrative Violation


(a)

A health care provider may not pursue a private claim against a workers’ compensation claimant for all or part of the cost of a health care service provided to the claimant by the provider unless:

(1)

the injury is finally adjudicated not compensable under this subtitle; or

(2)

the employee violates Section 408.022 (Selection of Doctor) relating to the selection of a doctor and the doctor did not know of the violation at the time the services were rendered.

(b)

A health care provider commits an administrative violation if the provider violates Subsection (a).
Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.
Amended by:
Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 3.248, eff. September 1, 2005.

Source: Section 413.042 — Private Claims; Administrative Violation, https://statutes.­capitol.­texas.­gov/Docs/LA/htm/LA.­413.­htm#413.­042 (accessed Jun. 5, 2024).

413.002
Medical Review
413.003
Authority to Contract
413.004
Coordination with Providers
413.006
Advisory Committees
413.007
Information Maintained by Division
413.008
Information from Insurance Carriers
413.011
Reimbursement Policies and Guidelines
413.012
Medical Policy and Guideline Updates Required
413.013
Programs
413.014
Preauthorization Requirements
413.015
Payment by Insurance Carriers
413.016
Payments in Violation of Medical Policies and Fee Guidelines
413.017
Presumption of Reasonableness
413.018
Review of Medical Care if Guidelines Exceeded
413.019
Interest Earned for Delayed Payment, Refund, or Overpayment
413.020
Division Charges
413.021
Return-to-work Coordination Services
413.022
Return-to-work Reimbursement Program for Employers
413.023
Information to Employers
413.024
Information to Employees
413.025
Return-to-work Goals and Assistance
413.031
Medical Dispute Resolution
413.032
Independent Review Organization Decision
413.041
Disclosure
413.042
Private Claims
413.043
Overcharging Prohibited
413.044
Sanctions on Designated Doctor
413.051
Contracts with Review Organizations and Health Care Providers
413.052
Production of Documents
413.053
Standards of Reporting and Billing
413.054
Immunity from Liability
413.055
Interlocutory Orders
413.0111
Processing Agents
413.0112
Reimbursement of Federal Military Treatment Facility
413.0115
Requirements for Certain Voluntary or Informal Networks
413.0141
Initial Pharmaceutical Coverage
413.0311
Review of Medical Necessity Disputes
413.0312
Review of Medical Fee Disputes
413.0511
Medical Advisor
413.0512
Medical Quality Review Panel
413.0513
Confidentiality Requirements
413.0514
Information Sharing with Occupational Licensing Boards
413.0515
Reports of Chiropractor Violations
413.05115
Medical Quality Review Process
413.05121
Quality Assurance Panel
413.05122
Medical Quality Review Panel: Rules

Accessed:
Jun. 5, 2024

§ 413.042’s source at texas​.gov