Within its service area, a certified WC Network (Network) is required to ensure that its provider panel
includes:
- An adequate number of treating doctors and specialists, who must be available to employees 24
hours a day, seven days a week; - Sufficient numbers and types of health care providers to ensure choice, access, and quality of
care to injured employees; - An adequate number of treating doctors and specialists who have admitting privileges at one or
more Network hospitals to make any necessary hospital admissions; - Hospital services that are available and accessible 24 hours a day, seven days a week;
- Physical and occupational therapy services and chiropractic services that are available and
accessible; - Emergency care that is available and accessible 24 hours a day, seven days, a week without
restrictions as to where the services are rendered; and - An adequate number of doctors who are qualified to provide maximum medical improvement
and impairment rating services as required under Labor Code Section 408.023.
If either a Network or the Texas Department of Insurance identify any underserved portions within a
Network’s service area, the Network must file an access plan with the department if any health care
service or a network provider is not available to an employee because:
- Providers are not located within the required distances; or
- The Network is unable to obtain provider contracts after good faith attempts; or
- Providers meeting the Network’s minimum quality of care and credentialing requirements are
not located within the required distances in portions of the Network’s service area.
The Network’s access plan must be approved by the department at least 30 days before the Network may
implement it.
A Worker's Compensation Health Care Network Access Plan Checklist (LHL708) is available.