1. (a) The executive director may delegate the authority to issue interlocutory orders for accrued and/or future medical benefits to Division staff, in accordance with §402.042 of the Texas Labor Code.

2. (b) The Division may enter an interlocutory order for accrued or future medical benefits when:

   1. (1) the Division determines that an insurance carrier has disputed medical benefits as the result of a liability, compensability, or extent of injury dispute that an insurance carrier has raised in accordance with §124.2 of this title (relating to Carrier Reporting and Notification Requirements), and the Division determines that those medical benefits are or were medically necessary and constitute essential medical treatment(s) and/or service(s) and are not subject to the medical dispute resolution process; or

   2. (2) At the conclusion of the medical dispute resolution process or an informal resolution conference, as set forth in §133.305 of this title (relating to Medical Dispute Resolution)

      1. (A) the Division determines that an insurance carrier has disputed medical benefits as the result of a liability, compensability, or extent of injury dispute that an insurance carrier has raised in accordance with §124.2 of this title, and the Division deems that the disputed medical benefits are or were medically necessary and constitute essential medical treatment(s) and/or service(s); or
      2. (B) the Division determines that future medical benefits for which preauthorization is required are medically necessary and constitute essential medical treatment(s) and/or service(s).
3. (c) The Commission shall enter an interlocutory order only when, absent the interlocutory order, the injured employee would not receive essential medical treatment.
4. (d) A party shall comply with an interlocutory order entered in accordance with this section on the earlier of the seventh day after receipt of the order or the date the Commission establishes in the body of the order.
5. (e) The insurance carrier may dispute an interlocutory order entered under this title by filing a written request for a hearing in accordance with §413.055 of the Texas Labor Code (relating to Interlocutory Orders; Reimbursement) and §133.305 and §148.3 of this title (relating to Requesting a Hearing).
6. (f) An insurance carrier that makes an overpayment pursuant to an interlocutory order may be eligible for reimbursement from the subsequent injury fund. An insurance carrier must make a request for reimbursement in accordance with §116.11 of this title (relating to Request for Reimbursement or Payment from the Subsequent Injury Fund).
7. (g) This rule shall apply for all requests submitted on or after July 15, 2000.

Source Note:The provisions of this §133.306 adopted to be effective July 15, 2000, 25 TexReg 2115.