For: American Airlines Group; CompPharma; Healthesystems; Insurance Council of Texas; Mitchell; myMatrixx; National Association of Mutual Insurance Companies; Optum Workers' Compensation and Auto No-Fault Division; Office of Injured Employee Counsel; Property Casualty Insurers Association of America; State Office of Risk Management.

Against: Alliance of Independent Pharmacists of Texas; Memorial Compounding Pharmacy; Texas AFL-CIO; several individuals on behalf of themselves.

Neither for or against: AIG.

The amendments are adopted under the authority of Labor Code §402.00111, Relationship Between Commissioner of Insurance and Commissioner of Workers' Compensation; Separation of Authority; Rulemaking; Labor Code §402.00116, Chief Executive; Labor Code §402.00128, General Powers and Duties of Commissioner; Labor Code §402.061, Adoption of Rules; Labor Code §408.021, Entitlement to Medical Benefits; Labor Code §408.028, Pharmaceutical Services; Labor Code §413.011, Reimbursement Policies and Guidelines; Treatment Guidelines and Protocols; Labor Code §413.013, Programs; Labor Code §413.014, Preauthorization Requirements; Concurrent Review and Certification of Health Care; Labor Code §413.053, Standards of Reporting and Billing; Insurance Code, Chapter 1305, Workers' Compensation Health Care Networks; Insurance Code §4201.054, Workers' Compensation Benefits; and Occupations Code §551.003, Definitions.

Labor Code §402.00111 states that the commissioner of workers' compensation shall exercise all executive authority, including rulemaking authority, under the Texas Workers' Compensation Act.

Labor Code §402.00116 states that the commissioner of workers' compensation is the division's chief executive and administrative officer and shall administer and enforce the Texas Workers' Compensation Act, other workers' compensation laws of this state, and other laws granting jurisdiction to or applicable to the division or the commissioner of workers' compensation.

Labor Code §402.00128 states that the commissioner of workers' compensation shall conduct the daily operations of the division and otherwise implement division policy and, among other functions, may delegate; assess and enforce penalties; and enter appropriate orders.

Labor Code §402.061 states that the commissioner shall adopt rules as necessary for the implementation and enforcement of the Texas Workers' Compensation Act.

Labor Code §408.021 states that an employee who sustains a compensable injury is entitled to all health care reasonably required by the nature of the injury as and when needed.

Labor Code §408.028 states that the commissioner of workers' compensation by rule shall adopt a closed formulary under §413.011 and that rules adopted by the commissioner of workers' compensation shall allow an appeals process for claims in which a treating doctor determines and documents that a drug not included in the formulary is necessary to treat an injured employee's compensable injury. In addition, this section states that the commissioner of workers' compensation shall by rule require the use of generic pharmaceutical mediations and clinically appropriate over-the-counter alternatives to prescription medications unless otherwise specified by the prescribing doctor, in accordance with applicable state law.

Labor Code §413.011 requires the commissioner of workers' compensation to adopt by rule treatment guidelines and return-to-work guidelines and medical policies designed to ensure the quality of medical care and to achieve effective medical cost control.

Labor Code §413.013 requires the commissioner to establish by rule a program for prospective, concurrent, and retrospective review and resolution of a dispute regarding health care treatments and services, and its monitoring.

Labor Code §413.014 states that the commissioner of workers' compensation by rule shall specify which health care treatments and services require express preauthorization or concurrent review by the insurance carrier. If a specified health care treatment or service is preauthorized as provided by this section, that treatment or services is not subject to retrospective review of the medical necessity of the treatment or service.

Labor Code §413.053 states that the commissioner by rule shall establish standards of reporting and billing governing both form and content.

Insurance Code, Chapter 1305 is the Workers' Compensation Health Care Network Act and contains treatment guidelines and authorization requirements applicable to certified networks.

Insurance Code §4201.054 states that the commissioner of workers' compensation shall regulate as provided by Chapter 4201 a person who performs utilization review of a medical benefit provided under Title 5, Labor Code, and that the commissioner of workers' compensation may adopt rules as necessary to implement section 4201.054.

Occupations Code §551.003 provides the definitions for "compounding" and "substitution."