February 2022

 

Feb. 18, 2022 - DWC Releases Health Care Provider Oversight Results for 2021

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The Texas Department of Insurance's Division of Workers’ Compensation (DWC) released the 2021 Health Care Provider Performance Based Oversight (PBO) assessment. For 2021, health care providers were assessed on their performance in one of two categories:

 

• DWC Form-069, Report of Medical Evaluation category; and

• DWC Form-073, Work Status Report category.

 

DWC reviewed 96 health care providers for the timeliness of filing the DWC Form-069, Report of Medical Evaluation (100% weight) with the following results: 66 had scores placing them in the high performer tier, 15 were in the average performer tier, and 15 had scores placing them in the poor performer tier.

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DWC reviewed 91 health care providers for the completeness of the DWC Form-073, Work Status Report (30% weight) and documentation supporting how the injured employee’s medical condition prevents them from returning to (any) work as reported on the DWC Form-073, Work Status Report (70% weight) with the following results: 45 had scores placing them in the high performer tier, 38 were in the average performer tier, and 8 had scores placing them in the poor performer tier. 

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The 2021 PBO assessment results and a list of the health care providers that were reviewed are posted on the TDI website.

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More information on PBO and the 2021 assessment are available on the TDI website. DWC will assess insurance carriers separately in 2022.

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​Feb. 18, 2022 - TDI Adds Nonprofit AG Health Plans to Dispute Resolution Rules

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The Texas Department of Insurance (TDI) has adopted amendments to the rules for Out-of-Network Claim Dispute Resolution and Disclosures by Out-of-Network Providers to include health benefit plans offered by nonprofit agriculture organizations, as authorized by House Bill 3924, 87th Legislature, 2021.

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The rule adoption order and amended rules can be found here. 

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Feb. 15, 2022 - Workers' Compensation Rate Filings Due June 1

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The Texas Department of Insurance accepts the National Council on Compensation Insurance advisory loss cost filing with an effective date of July 1, 2022. This filing proposes an overall average decrease of 7.4% to the current loss cost level.

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Insurers that currently write workers' compensation insurance and plan to continue writing that coverage on or after July 1, 2022, should submit a rate filing no later than June 1, 2022.

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See Bulletin B-0001-22 on the TDI website for more details. Also see the Texas workers' compensation rate guide.

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Feb. 4, 2022 - DWC Requests Comments on Work Status Report Form

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The Texas Department of Insurance, Division of Workers’ Compensation (DWC) is accepting public comments on proposed revisions to the DWC Form-073, Work Status Report. The updated form now requires HCPs to identify the injured employee's job classification if work restrictions are necessary.

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The proposed revised DWC Form-073 can be found here. Comments on the form must be received by 5 p.m., Central Standard Ttime, on Friday, March 4, 2022.

 

January 2022

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Jan. 28, 2022 - National Weather Service Warns that Powerful Nor'easter To Impact The East Coast 

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The National Weather Service has issued a warning that a powerful winter storm will develop off the Mid-Atlantic Coast today before racing northward and impacting areas along the coast from the Mid-Atlantic to Northeast and New England this afternoon through Sunday. People are urged not to travel under this warning.

 

Numerous hazards are likely from heavy snow, with significant accumulations to gusty winds and coastal issues. The combination of the snow and wind will lead to blizzard conditions.

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CBS has reported that winter storm watches and warnings have been issued for a large stretch of the U.S. East Coast ahead of a powerful Nor'easter set to hit in the coming hours. Parts of New Jersey, Maine, Massachusetts and Maryland are under blizzard warnings, which means severe winter weather — including whiteout conditions — is being seen or is expected within the next 12 to 36 hours. The blizzard could pile as much as 12 inches or more of snow according to the weather service's Weather Prediction Center.

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Eastern Massachusetts, including Boston, and Rhode Island could see between 12 to 24 inches of snow combined with wind gusts up to 64 mph, according to multiple forecast models. 

 

Information about Nor'easters and winter safety can be found here.   

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Jan. 28, 2022 - Cyberattacks Warning Issued

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The Department of Homeland Security (DHS) and the United Kingdom's (UK) National Cyber Security Centre (NCSC), a part of the UK's GCHQ eavesdropping intelligence agency, have issued a warning that as tensions rise in the standoff over the Ukraine, the U.S. and NATO response to a possible Russian invasion could result in a cyberattack or series of cyberattacks against the UK, U.S., and NATO member nations by the Russian government, its intelligence community and military, or its proxies.

 

Cyber security experts have warned that cyberattacks may already be underway. The Ukraine has already been the target of cyberattacks during the ongoing crisis. 

 

"Insurance companies, other companies, firms, and organizations should take all necessary and possible steps to protect their websites, claims management systems, and databases from possible cyberattacks that Russia may launch or may have already launched," said Steve Nichols, president of Sentinel Governmental Affairs. Nichols said, "the Treasury Department recently held a classified briefing that covered the issue for big US banks, while the Energy Department has briefed America's largest electric utilities on Russian cyber capabilities."

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Nichols noted that the Cybersecurity and Infrastructure Security Agency (CISA), Federal Bureau of Investigation (FBI), and National Security Agency (NSA) have released a joint Cybersecurity Advisory (CSA) that provides an overview of Russian state-sponsored cyber operations, including commonly observed tactics, techniques, and procedures that companies and other entities should review as they take the steps necessary to protect their organization from cyberattacks. 

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Nichols recommended that "network defenders" review CISA's Russia Cyber Threat Overview and Advisories page for more information on Russian state-sponsored malicious cyber activity.

 

The U.S. Department of Commerce's National Institute of Standards and Technology (NIST) has tips on how to protect your business from Cyberattacks which you can view here. 

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Jan. 28, 2022 - TDI Proposes Rule Establishing a Grace Period for TWIA Renewal Payments

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The Texas Department of Insurance (TDI) has proposed a rule establishing a grace period for TWIA renewal premium payments. House Bill (HB) 2920 requires TDI to adopt rules to establish a grace period of not more than 10 days after the due date for the receipt of payment of premium for the renewal of a policy. The proposed new rule, Rule 5.4906, implements HB 2920.

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TDI is seeking comments on the proposed new rule. Comments must be submitted to TDI no later than 5:00 p.m., Central Standard Time, on February 28, 2022.

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The proposed rule and instructions for submitting written comments to TDI can be found here.

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Jan. 28, 2022 - DWC Requests Comments on Nonsubscriber Employer Form

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The Texas Department of Insurance's Division of Workers’ Compensation (DWC) is accepting public comments on proposed revisions to DWC Form-007, Employer’s Report of Noncovered Employee’s Occupational Injury or Disease.

 

Texas Labor Code Section 411.032 requires employers to file a report with DWC for each on-the-job injury that results in the employee's absence from work for more than one day and for an occupational disease of which the employer has knowledge. The form allows nonsubscribing employers to report these injuries to DWC. The revisions update the forms to meet new DWC forms standards.

 

The revised forms are not a formal rule proposal under the Administrative Procedures Act. DWC will not treat comments as formal public comments.

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Comments on the draft form must be submitted no later than 5 p.m., Central Standard Time, on Friday, February 11, 2022.

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The draft form can be found here. 

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Jan. 26, 2022 - NCCI Proposes Revisions to Experience Rating and Statistical Plan Manuals

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The National Council on Compensation Insurance (NCCI) filed Item E-1408—Revisions for New York Withdrawal from the NCCI Interstate Experience Rating Plan to revise references to New York regarding its participation in NCCI's interstate experience rating plan.

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NCCI's filing says the New York Experience Rating Plan no longer permits New York experience to be used in NCCI's interstate experience rating plan.

 

NCCI proposed that the changes be effective for new and renewal workers' compensation policies issued on or after 12:01 a.m. on October 1, 2022.

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NCCI's filing can be found here. TDI's notice of the filing is available here. 

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Jan. 26, 2022 - DWC Announces Upcoming Health Care Provider Lunchtime Webinars

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The Texas Department of Insurance's Division of Workers' Compensation (DWC) has announced upcoming health care provider lunchtime webinars. The webinars have been developed for health care providers and medical office staff who provide health care to Texas workers’ compensation injured employees.

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DWC announced the following upcoming webinars:

 

• February 1 - Medical Fee Dispute Resolution – Learn how to resolve your workers’ compensation medical fee disputes.

 

• February 15 - The Preauthorization Process: Utilization Review and Medical Necessity – Learn how to request workers’ compensation preauthorization.

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DWC's full schedule of healthcare provider webinars can be found here. 

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Jan. 25, 2022 - Texas, Oklahoma, Arkansas Among States with Highest Frozen Pipe Claims

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The Insurance Journal reported that State Farm paid more than $471 million in claims from frozen pipes in 2021, and more than two/thirds of claims can be rooted back to one state: Texas. 

 

The Lone Star State accounted for $343 million of frozen pipes claim cost last year, driven by February 2021 Winter Storm Uri which brought single digit temperatures across much of the state. The average claim for a frozen pipe in Texas was $22,000.

 

Oklahoma saw the third-highest claims cost at $21 million, with an average claim of $16,000. Arkansas was fourth highest at $12 million in claims cost with an average $16,000, while Louisiana was sixth on the list, costing $7.9 million in frozen pipe claims with an average of $9,000.

 

Read the rest of the news story here. 

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Jan. 25, 2022 - TDI Rule Requires Email Contact for All Licensees

 

The Texas Department of Insurance (TDI) reminds individuals, agencies, and companies regulated by TDI to designate an email address for official communications from TDI.

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If you have not already provided your email address or if you need to update it, you can do so by clicking on the appropriate link:

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• Insurance companies and HMOs

• TPAs and premium finance companies

• Agents, adjusters, and agencies

• URAs and IROs

• Workers’ compensation networks

• Fire-industry licensees

 

This rule went into effect January 1, 2022. View the adoption order (PDF) for details.

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Jan. 24, 2022 - Sentinel Submits Comments on DWC's Proposed Claims EDI Rules

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Sentinel Governmental Affairs (Sentinel) has submitted written comments on DWC's proposed claims EDI rules and asked that the effective be pushed back to allow for a more adequate testing period. The comments which were prepared and submitted on behalf of MedicusRx were filed by Steve Nichols, Sentinel's president. MedicusRx is a Texas-based third-party claims administrator and utilization review agent.

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Nichols said, "MedicusRx both applauds and supports the move to Release 3.1.4. One of the most important impacts of the proposed change is the ability of new claims data reporting standard to capture information about whether a claim is enrolled in a certified workers’ compensation network under Insurance Code, Chapter 1305 or a political subdivision network under Labor Code, Section 504.053. The change also moves DWC’s claims data collection from an obsolete standard that is no longer supported nor updated by the International Association of Industrial Accident Boards and Commissions (IAIABC) to one which is both supported and updated as necessary."

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MedicusRX is seeking a 3 to 4-month delay of the proposed July 26, 2023 effective date of the proposed rules to provide adequate time for beta testing and implementation of the new Release 3.1.4 reporting standard by insurance carriers, third-party claims administrators, EDI trading partners, and DWC. 

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"The delay in the effective date will allow insurance companies and their vendor to move forward with the reporting of claims using the new reporting format without major issues that could impact DWC’s receipt of data and/or the accuracy of the reported data," said Nichols. "To accommodate insurance companies and vendors that are ready to submit claims data utilizing Release 3.1.4 prior to the revised effective date of the rule, the rule should provide that if an insurance carrier and/or their vendors demonstrate to DWC that they can submit their claims data using Release 3.14, the insurance company and/or vendor may submit data utilizing the Release 3.1.4 standard at a date earlier than the effective date of the rule."

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DWC's proposed amended Chapter 102 EDI rules are available here. The proposed amended Chapter 124 rules can be viewed here. 

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A copy of MedicusRx's written comments can be found here. 

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Jan. 19, 2022 - Ruling on Vaccine Mandates Doesn’t Bar Employers from Proceeding

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Business Insurance has reported that the recent U.S. Supreme Court decision blocking COVID-19 vaccine mandates for large employers muddies the issue for businesses that have their own mandates in place or want to proceed with one. But the ruling won’t bar employers who are determined to require that their workers are vaccinated.

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On Jan. 13, three days into the Occupational Safety and Health Administration’s implementation of the emergency temporary standard requiring vaccinations or weekly testing for employees at companies with 100 or more workers, the country’s highest court halted the mandate, ruling 6-3 that OSHA did not have the authority to regulate public health policy, among other reasons, and sent the case back to the 6th Circuit Court of Appeals for further deliberations.

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In a separate ruling, the Supreme Court allowed the Centers for Medicare & Medicaid Services vaccine mandate to go into effect, requiring vaccinations for health care workers in facilities that accept Medicare and Medicaid.

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Meanwhile, employers must still contend with mandates in some jurisdictions. New York City, for example, requires that all workers be vaccinated.

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Many employers unaffected by the existing federal and local mandates already required vaccinations, which is within their rights as private employers, legal experts say.

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Read the rest of the news story here. 

 

Jan. 18, 2022 - DWC Updates Form with New Address

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On June 8, 2021, DWC issued a plan to update notices and forms with a new letterhead and mailing address.

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DWC has updated DWC Form-153, Request for Record Check or Copies of Confidential Claim Information for address information only. The form does not have a new revision date.

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Additional information about the updated form is available here. 

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Jan. 17, 2022 - Health Insurance Costs Keep Rising in Texas — Here’s Why

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Austin television station KXAN has reported that insurance costs keep going up, and Texans are often paying more than people in other states. The findings come from a new report from The Commonwealth Fund, which supports independent research on health care issues.

 

The report found that Texans spent more than 14.2% of the median income on premium contributions and deductibles in 2020. That added up to $9,311. 

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Sara Collins, vice president at The Commonwealth Fund, said rates keep going up because healthcare providers and drug companies are charging more than in the past. Collins said, "Texans are doubly disadvantaged. They’re paying more on average for their premiums and deductibles, and also have just lower median incomes on average."

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When it comes to what can be done to lower costs, Collins points to some of the provisions in the Build Back Better Act. “The Build Back Better bill that’s under consideration in Congress right now would actually make it possible for more people with expensive employer plans to get covered through the marketplaces,” she said.

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Read the rest of the news story here. 

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Jan. 14, 2022 - TDI Adopts Repeal of Obsolete Rule

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The Texas Department of Insurance (TDI) adopts the repeal of 28 Texas Administrative Code Section 5.6302 relating to the sale of substitutes to workers’ compensation insurance. Legislation passed in 2021 makes this rule redundant and obsolete. Each provision of the rule is now superseded or addressed by statute.

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View the adoption order (PDF) for the full text.

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For other dates and documents related to this action, visit TDI’s 2021 rules webpage.

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Jan. 13, 2022 - Texas Windstorm Insurance Association Files Aapplication Forms for Approval

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The Texas Windstorm Insurance Association (TWIA) has filed revised commercial application forms with the Texas Department of Insurance (TDI) for approval:

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• Builder's Risk

• Condo Building Master

• Habitational (Not Condo)

• Business Property Only

• Building and Business Personal Property

 

TWIA is updating its electronic application forms to allow users to print them, making it easier for agents and policyholders to review. TWIA notes that the information requested in the new forms is substantially similar to that of the existing forms.

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Visit TDI's TWIA Submissions webpage to view the dates and documents related to this action (see proposals filed 1/7/2022), and to learn how to submit comments or request a hearing on the application forms.

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Jan. 13, 2022 - DWC Adopts Shoulder Surgery Plan-Based Audit

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The Texas Department of Insurance's (TDI) Division of Workers' Compensation (DWC) has adopted the Shoulder Surgery Plan-Based Audit. Medical quality reviews initiated on or after January 1, 2022, will follow the approved Medical Quality Review Process in effect.

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The Process and Plan-Based Audit are posted on TDI's website.  

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Jan. 12, 2022 - Business Owner Facing Trial for $1.1 Million Insurance Fraud Scheme 

 

A Houston area businessman faces multiple charges in connection with a long-running premium fraud scheme. Police in Stafford, Texas arrested Kunal “Sonny” Puri on January 11, 2022. 

 

Puri was transferred to the Fort Bend County jail where he posted a $20,000 bond.

In December, a Travis County grand jury returned two indictments against Puri and several of his corporations including Sehgal & Sons Enterprises, Ultra Building Services Inc, and Ultra Medical Cleaning & Environmental Services.

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It’s alleged that for a period of seven years from July 24, 2009, to August 16, 2016, Puri, of Stafford, Texas hid employees and their payroll under other companies to lower workers’ compensation insurance premiums and obtain work contracts.

 

The DWC Prosecution and Fraud Units worked closely with the affected insurance carriers, Texas Mutual Insurance Company, Service Lloyds, and Travelers.

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Read the rest of the story here. 

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Jan. 11, 2022 - DWC Announces Methodology and Measures for 2022 Insurance Carrier Performance Based Oversight Assessment 

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As part of the overall compliance plan, the Texas Labor Code mandates that the Texas Department of Insurance's Division of Workers' Compensation (DWC) assess the performance of insurance carriers every two years. DWC achieves its compliance objectives through performance-based oversight (PBO), data monitoring, complaint handling, audits, and enforcement actions.

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DWC has announced the 2022 Insurance Carrier PBO measures and methodology. The following measures will be assessed:

 

• Timely payment of initial Temporary Income Benefits by the insurance carrier

 

• Timely processing of initial medical bills by the insurance carrier

 

• Timely processing of request for reconsideration medical bills by the insurance carrier

 

• Timely submission of Initial Payment data via Electronic Data Interchange (EDI)

 

• Timely submission of Medical Bill Processing data via EDI

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The data time frame that will be used to assess performance of the insurance carriers selected for the 2022 PBO assessment will be January 1, 2022, through June 30, 2022.

 

Based on the performance assessment, insurance carriers will be placed into three regulatory tiers: poor, average, and consistently high performers. DWC will focus its regulatory oversight on poor performers.

 

DWC's 2022 PBO methodology paper can viewed here. Additional 2022 PBO information can be found here. 

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Jan. 10, 2022 - Over 100 Insurers Sue Texas Electric Authority, Utilities Over 2021 Winter Storm Damage

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Insurance Business America reported that the Electric Reliability Council of Texas (ERCOT) and several local power companies in the state are facing a massive lawsuit filed by more than 100 insurance companies over damages related to the grid failure that occurred during the February 2021 winter storm.

 

Filed in Travis County, the lawsuit alleges that ERCOT is responsible for the power failure last year, additionally claiming that the issue was entirely preventable. According to the lawsuit, ERCOT “failed to adequately prepare for the 2020-2021 winter season, and in fact, planned to fail.”

 

The February 2021 power outage led to more than 500,000 insurance claims and over 200 deaths. It was estimated that insurers were anticipated to pay more than $10 billion for damages related to the outage.

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Read the full story here. 

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Jan. 10, 2022 - 2021 Insured Cat Losses Roughly $120bn, December Tornadoes $4bn

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According to Artemis, global reinsurance giant Munich Re has estimated that insurance industry losses from natural disasters or catastrophes in 2021 were roughly US $120 billion, the second-highest annual total ever.

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This is a higher total than most sources had been discussing. The insurance industry had been hearing that annual natural catastrophe and severe weather insured losses might reach $110 billion, once the December tornado outbreak in the United States was added to earlier preliminary totals.

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Part of the reason for this is that Munich Re has put a number on the US tornado outbreak in December, saying that economic losses are estimated to be around $5.2 billion and the insured losses from the tornadoes would be around $4 billion.

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Read the full story online.

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Jan. 7, 2022 - DWC Announces 2022 Safety Pro Seminars

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The Texas Department of Insurance's Division of Workers' Compensation (DWC) has announced that Workplace Safety offers free safety pro seminars for new safety professionals or coordinators. These online seminars provide the basic information on developing an effective workplace safety program.

 

Presentations will cover: 

 

• Safety and Health Program Development (Part One)

• Recordkeeping (Part Two)

 

The training is held on two different days. Attendance to both courses is highly encouraged for all new safety professionals or coordinators. 

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Additional information and registration are available on DWC's website. 

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Jan. 6, 2022 - 3 Life Insurance Underwriting Predictions for 2022 and Beyond

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Accenture reported that the life insurance and annuity industry proved resilient in 2021, even in the face of COVID-19 and the delta variant. 

 

Digital transformation will accelerate in the coming year, and we’ll witness technology and human ingenuity working together to deliver underwriting innovation. 

 

When it comes to life insurance underwriting, it’s the underwriters themselves who are the heart of human ingenuity. They are optimistic about their future, and they are embracing change.

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Accenture's 2022 predictions for the life insurance and annuity industry include:

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• Underwriting will be at the center of the customer experience conversation

• AI-led underwriting leaders will pull away from the pack

• Underwriting will contribute to insurers’ Environment, Sustainability and Governance (ESG) programs

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Read the rest of the news story here. 

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Jan. 6, 2022 - Fraud Investigation Yields Guilty Plea from Former Houston NFL Player

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Shantee Orr, one of eight former NFL players accused of taking part in a scheme to defraud a player health care reimbursement fund, pleaded guilty Wednesday in Harris County of submitting false claims totaling more than $129,000.

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The case was led by Texas Department of Insurance (TDI) investigators and prosecutors working with the Harris County District Attorney’s Office. 

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TDI's press released can be viewed here. 

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Jan. 5, 2022 - DWC Schedules Public Hearing on Electronic Data Interchange Rule Proposals

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Texas Department of Insurance's Division of Workers' Compensation has scheduled a public hearing for Tuesday, January 18, 2022, to consider written and oral comments on the electronic data interchange rule proposals in a virtual public hearing. The meeting will be via Zoom from 10 a.m. to 12 p.m. 

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Information about the public hearing and instructions on how to log onto the Zoom meeting can be found here. 

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Jan. 5, 2022 - TDI Has Adopted NCCI's Catastrophe Provision

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The Texas Department of Insurance (TDI) has adopted the National Council on Compensation Insurance's (NCCI) filing Item 02-TX-2021—Rules and an Endorsement Related to the Catastrophe (Other Than Certified Acts of Terrorism) Provision in Texas. 

 

The changes apply to new and renewal policies effective on or after 12:01 a.m. on July 1, 2022.

 

Item 02-TX-2021:

 

• Revises rules 3-A-24-b and 3-A-24-c in NCCI's Basic Manual to include Catastrophe (Other Than Certified Acts of Terrorism);

 

• Revises the Texas Workers Compensation Premium Algorithm in NCCI's Basic Manual to include Catastrophe (Other Than Certified Acts of Terrorism);

 

• Establishes an entry in the Texas Miscellaneous Values to state that if a carrier plans to apply the Catastrophe (Other Than Certified Acts of Terrorism) premium, then it must file its Catastrophe (Other Than Certified Acts of Terrorism) rate with TDI;

 

• Establishes national rules 1-B-1-c and 1-B-1-f and eliminates the corresponding Texas exceptions in NCCI's Retrospective Rating Plan Manual;

 

• Establishes Statistical Code 9741 - Catastrophe Provisions for Catastrophe (Other Than Certified Acts of Terrorism) in NCCI's Statistical Plan for use in Texas;

 

• Establishes the Catastrophe (Other Than Certified Acts of Terrorism) Premium Endorsement (WC 00 04 21 F) in NCCI's Forms Manual; and

 

• Makes nonsubstantive style and formatting changes.

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An overview of the NCCI filing can be found here. 

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Jan. 5, 2022 - DWC Publishes January Edition of the Safety@Work Newsletter

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The Texas Department of Insurance's Division of Workers' Compensation (DWC) has published the latest edition of the Safety@Work newsletter. 

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The January edition of the newsletter includes articles on the importance of proper lockout/tagout procedures, DWC's new safety pro seminars and the new safety publications.

 

View the newsletter here.  

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​Jan. 5, 2022 - Pandemic-wary Supreme Court to Weigh Vaccine Mandates

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Business Insurance has reported that the U.S. Supreme Court, which has restricted its own operations during the COVID-19 pandemic, is preparing to decide whether to block President Joe Biden's vaccine mandates for large businesses and health care workers in a test of presidential powers to address an unyielding public health crisis.

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On Jan. 7. 2021, the court will hear in-person arguments on emergency requests in two separate cases by challengers including business groups, religious entities and various Republican-led U.S. states for orders blocking the vaccine requirements, with rulings expected in short order. The challengers maintain that Mr. Biden and his administration have overstepped their authority.

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Read the rest of the news story here. 

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Jan. 4, 2022 - Texas Tribune Reports That 1 in 3 COVID-1 Tests Are Coming Back Positive in Texas and There Has Been Nearly One Million New Infections Nationwide

 

According to Texas Tribune, Texas is reporting that 1 in 3 COVID-19 tests are coming back positive, a record high, as omicron spreads. The share of positive cases reported is called the positivity rate. A rate over 10% puts states in the “red zone,” according to federal guidance. Texas is far past that threshold at 34.4%. 

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As of Jan. 4, the state has reported around 4.8 million cases, with 4 million confirmed cases and 820,591 probable cases reported since the pandemic began. Confirmed cases are detected by molecular PCR lab tests, which are taken with a nasal swab and are highly accurate according to the U.S. Food and Drug Administration. Probable cases are detected through rapid antigen tests, which are faster and less accurate.

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Read the rest of the news story here. 

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Texas Tribune also reported that the number of Texans hospitalized each day with COVID-19 continued to rise over the New Year’s holiday, according to state health numbers released Monday, as the omicron variant continues to drive new cases and hospitals await desperately needed staffing help to respond to new admissions.

 

As of Monday, more than 7,000 Texans were hospitalized with COVID-19, more than double the number two weeks ago but still far below the pandemic peak of 14,218 on Jan. 11, 2021.

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According to Reuters, The United States reported nearly 1 million new coronavirus infections on Jan. 3, 2021, the highest daily tally of any country in the world and nearly double the previous U.S. peak set a week ago as the spread of the Omicron variant showed no signs of slowing. 

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Nationally, the United States has seen a daily average of 486,000 new cases over the past week, a rate that has doubled in seven days and far outstrips that of any other country.

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Jan. 4, 2022 - DWC Reminds Health Care Practitioners About Financial Interest Disclosures

 

The Texas Department of Insurance's Division of Workers' Compensation (DWC) has reminded health care practitioners that they must file a financial interest disclosure with DWC when referring an injured employee to another health care practitioner, health care provider, or health care facility that they have a financial interest in.

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The financial disclosure must be made no later than 30 days after the date of the initial referral.

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Additional information regarding the financial disclosure requirement can be found here and on DWC's website. 

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Jan. 3, 2022 - OSHA to Extend Parts of Emergency Standard for Health Care Workers

 

Business Insurance reported that the Occupational Safety and Health Administration has published a 30-day request for comments to extend certain portions of its Healthcare Emergency Temporary Standard, which expired Dec. 21.

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On Dec. 27, OSHA announced that “it intends to continue to work expeditiously to issue a final standard that will protect health care workers from COVID-19 hazards and will do so as it also considers its broader infectious disease rulemaking.”

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Read the rest of the news story here. 

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December 2021

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Dec. 31, 2021 - Omicron Coronavirus Variant is Not the Common Cold

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Misinformation aimed at downplaying the severity of the coronavirus has spread online since the early days of the pandemic. One of the most pervasive falsehoods is the claim that COVID-19 is just another strain of the seasonal flu.

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Now, some social media users have targeted the latest coronavirus variant. “Omicron is the common cold people,” reads a Dec. 27 Facebook post.

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The claim comes as the U.S. reports record-breaking COVID-19 infections, in part due to the spread of the highly contagious omicron variant. Similar versions of the claim have been shared to Facebook and Twitter.

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The Omicron COVID-19 variant is not the common cold.

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Read the rest of the news story here and learn why the new COVID-19 variant is not the common cold. 

 

Dec. 30, 2021 - Opioid Scripts Decreased But Fatal Overdoses Increased, Doctors Urge New Approach

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The Insurance Journal reported that doctors with the American Society of Anesthesiologists are calling for a new approach to fighting the opioid crisis, one that goes beyond current efforts at restricting opioid prescribing to reducing demand and addressing the “illicit” opioids in medicine cabinets.

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To address the U.S. opioid epidemic, policies and guidelines have focused primarily on reducing opioid prescribing and restricting supply. Accordingly, opioid prescribing decreased 38% in the past decade.

Nevertheless, fatal opioid overdoses actually increased 300% during that period.

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Read the rest of the news story here. 

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Dec. 29, 2021 - TDI Issues Annual Title Underwriters Data Call

 

The Texas Department of Insurance (TDI) has issued the calendar year 2020 data call to title insurance underwriters in Texas. State law requires title underwriters to report data that is used to set rates.

 

The data reports are due February 28, 2022.

 

Check TDI’s website for Commissioner's Bulletin # B-0031-21, reporting instructions and forms which must be used to respond to the data call.

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Dec. 29, 2021 - Drugmaker Endo Strikes $63 Million Opioid Settlement with Texas

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The Insurance Journal reported that Endo International Plc has agreed to pay $63 million to resolve claims by the state of Texas and local governments that the drugmaker helped fuel the U.S. opioid epidemic, the state’s attorney general said on Thursday. 

 

The deal announced by Texas Attorney General Ken Paxton marked the latest in a series of settlements that Endo has struck in recent months with state and local governments to resolve similar cases.

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Read the rest of the news story here. 

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Dec. 29, 2021 - Texas Nonsubscriber Told to Pay $1 million to Worker

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Business Insurance reported that Texas’ position as the only state that allows employers not to carry workers compensation coverage can create unusual legal wrangles for companies. 

 

In January a nonsubscriber to Texas’ workers compensation insurance program was ordered to pay $930 million in damages to a worker injured on the job by a forklift. 

 

In Load Trail LLC v. Julian, the Texas Court of Appeals, Sixth District, in Texarkana affirmed a trial court’s ruling upholding an arbitrator’s decision that the employer negligently failed to provide a safe workplace.

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Read the rest of the news story here. 

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Dec. 29, 2021 - OSHA Vaccine Mandate Met Resistance

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Business Insurance reported that almost immediately after the Biden administration’s vaccine mandate for private employers was announced, state lawsuits poured in challenging its legality.

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On Nov. 6, two days after it was rolled out, the 5th U.S. Circuit Court of Appeals in New Orleans temporarily blocked the mandate, which would require workers at companies with 100 or more employees to be fully vaccinated by Jan. 4, 2022, or be tested weekly.

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On Nov. 12, the appellate court reaffirmed its prior temporary injunction, placing a hold on the mandate’s implementation. On Nov. 16, a judicial panel consolidated 34 lawsuits challenging the mandate, and the case was randomly selected to be heard by the 6th U.S. Circuit Court of Appeals in Cincinnati.

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The 6th U.S. Circuit Court delivered a win for the Biden administration late in the evening on Dec. 17, upholding the employer vaccine mandate and allowing its implementation. 

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Read the rest of the news story here. 

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Dec. 29, 2021 - Mandatory Vaccine Policies Came with Workers Comp Implications

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Business Insurance reported that mandatory vaccinations in the workplace became a hot-button issue early in the rollout of the COVID-19 vaccines. When the vaccines first became available in late 2020 and

early 2021 the notion of mandating vaccinations for workers, such as those in health care and at senior living facilities across the U.S., came with one potentially hefty side effect: workers compensation if a worker suffers side effects.

 

Read the rest of the news story here. 

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Dec. 28, 2021 - Two More Circuit Courts Reject COVID-19 Business-Interruption Claims

 

The Claims Journal reported that the 2nd Circuit Court of Appeals ruled Monday that the coronavirus did not cause a direct physical damage or loss to a New York City art gallery — issuing the latest in a long series of defeats for policyholders seeking coverage for losses caused by pandemic closure orders. It was the second federal appellate court ruling within a week that rejected a COVID-19 business-interruption claim. The 10th Circuit on Dec. 21 affirmed dismissal of a similar lawsuit filed by Goodwill Industries.

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Read the rest of the news story here. 

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Dec. 28, 2021 - Flooding Projected to Cost Businesses $13.5B Next Year

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The Claims Journal reported that a new report estimates that U.S. businesses could spend about $13.5 billion in 2022 to repair or replace flood-damaged commercial buildings. The same report finds that businesses could lose more than 3.1 million days of operation from flooding next year.

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The report, titled “The 4th National Risk Assessment: Climbing Commercial Closures,” from the nonprofit First Street Foundation and global engineering firm Arup, provides insights for communities at risk of flooding. The report assesses the risk of flood damage to 3.6 million retail, office, and multi-unit residential properties across the country and related economic impacts.

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Read the rest of the news story here. 

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Dec. 28, 2021 - 5 Predictions for the Insurance Industry in 2022

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Accenture reported that this time last year the world was eager for COVID-19 vaccines to end the pandemic and the need for physical distancing and restrictions on travel. While we saw some relief, new variants have emerged, demanding our continued vigilance in controlling the spread of the virus.

 

Despite the continued uncertainty, the economic recovery also continues with global GDP expected to grow 4.9% in 2022. This GDP growth would suggest that greater demand for insurance products and services lay ahead.

 

As stated in Accenture's Insurance Revenue Landscape 2025 report, global insurance industry revenues are expected to grow to $7.5 trillion by the end of 2025. Here are five scenarios insurers looking to capture a share of that revenue in 2022 will need to consider.

 

The scenarios include:

 

• Electric vehicles to emerge as a growth segment for insurers

• Sustained supply chain and inventory management risk will accelerate product reinvention

• A property pricing and profitability reckoning is coming

• Insurance operating models will adjust to seismic shifts

• Resetting the underwriting workflow

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Read the full news story here. 

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Dec. 27, 2021 - TWIA Files Revised Declarations Pages

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The Texas Windstorm Insurance Association (TWIA) has filed revised declarations pages with the Texas Department of Insurance (TDI) for approval.

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TWIA is revising its residential and commercial declarations pages as part of its policy administration system upgrades. TWIA explained that revisions should make the declarations pages easier to read and are substantially similar to the existing declarations pages.

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Visit TDI's TWIA Submissions webpage (see proposals filed December 20, 2021) to view the dates and documents related to this action, and to learn how to submit comments or request a hearing.

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Archived News Briefs may be viewed here. 

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