Coronavirus (COVID-19) - authorizing pharmacy prescriptions and resuming medical billing timelines

Home Bulletins Commissioner bulletins – 2021 B-0004-21 January 29, 2021 To:   All Texas workers’ compensation system participants Re:   Coronavirus (COVID-19) - authorizing pharmacy prescriptions and resuming medical billing timelines On March 13, 2020, Governor Greg Abbott declared COVID-19 a statewide public health disaster. In response to this declaration and the impact COVID-19 was having on the workers’ compensation system, on March 25, 2020, the Texas Department of Insurance, Division of Workers’ Compensation issued Commissioner’s Bulletin # B-0010-20 . The bulletin required insurance carriers to authorize payments to pharmacies for up to a 90-day supply of any prescription medication and tolled (paused) medical billing deadlines. These specific requirements are no longer necessary, and the 90-day prescription requirement and the tolling of medical billing deadlines will be lifted effective March 1, 2021 . The effect of lifting the tolling period means that the “clock” for submitting a medical bill will resume “ticking” on the effective date the tolling period is lifted. For example, if a medical service was provided on April 1, 2020, the 95-day billing deadline would begin to run on March 1, 2021, the day the tolling period will be lifted. The result of lifting the 90-day prescription requirement means that effective March 1, 2021, insurance carriers are no longer required to pay for up to a 90-day supply for any prescription medication refill dispensed after this date, regardless of the date the prescription was most recently filled. This bulletin supersedes the requirements in Commissioner's Bulletin #B-0010-20 related to those requirements for authorizing pharmacy prescriptions and medical billing timelines. For more information, please use the contact information below. Health care providers CompConnection@tdi.texas.gov 800-252-7031, Option 3 Medical Fee Dispute Resolution MDRInquiry@tdi.texas.gov 800-252-7031, Option 3 Claims and Customer Service 800-252-7031, Option 1 Cassie Brown Commissioner of Workers’ Compensation Texas Department of Insurance, Division of Workers’ Compensation For more information, contact: Accessibility@tdi.texas.gov Last updated: 8/8/2023