Today, the Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC) released the results of the 2011 Health
Care Provider PBO assessment. For 2011, health care providers were assessed on their performance in one of three categories:
• timely filing of the DWC Form-069, Report of Medical Evaluation; or
• timely release to return to work and completeness of the DWC Form-073, Work Status Report; or
• usage of magnetic resonance imaging.
The TDI-DWC is statutorily required to monitor system participants’ compliance with the Texas Workers’ Compensation Act and TDI-
DWC rules and to take actions to correct noncompliant behavior. The TDI-DWC assesses the performance of insurance carriers and
health care providers as a part of a biannual Performance Based Oversight (PBO) assessment.
Of the 99 health care providers reviewed for the timeliness of filing the Report of Medical Evaluation, 87 health care providers had
scores placing them in the high performer tier, 10 health care providers were in the average performer tier, and 2 health care providers had
scores placing them in the poor performer tier.
Of the 100 health care providers reviewed for the timely release to return to work and completeness of the Work Status Report, 49
health care providers had scores placing them in the high performer tier, 34 health care providers were in the average performer tier, and
17 health care providers had scores placing them in the poor performer tier.
Of the 41 health care providers reviewed for the usage of magnetic resonance imaging, 32 health care providers had scores placing them in
the high performer tier, 9 health care providers were in the average performer tier, and no health care providers had scores placing them in
the poor performer tier. This category was a pilot measure and individual results will not be made public.
The TDI-DWC uses Performance Based Oversight, data monitoring, complaint handling, audits, enforcement actions and referrals to law
enforcement, when appropriate, to achieve its compliance objectives. The TDI-DWC will focus its regulatory oversight on the poor
performers while offering incentives for high performers in order to promote improved performance and greater overall compliance with
the Workers’ Compensation Act and TDI-DWC rules.
The results of the 2011 PBO assessment and a list of the health care providers assessed are posted on the TDI website. The omission of
a health care provider from the list does not imply that a health care provider participating in the Texas workers’ compensation system
is exempt from the requirement to comply with the Workers’ Compensation Act and TDI-DWC rules.
Further information regarding PBO and the 2011 assessments may be found on the TDI website at http://www.tdi.texas.
gov/wc/pbo/hcppbo.html.
Care Provider PBO assessment. For 2011, health care providers were assessed on their performance in one of three categories:
• timely filing of the DWC Form-069, Report of Medical Evaluation; or
• timely release to return to work and completeness of the DWC Form-073, Work Status Report; or
• usage of magnetic resonance imaging.
The TDI-DWC is statutorily required to monitor system participants’ compliance with the Texas Workers’ Compensation Act and TDI-
DWC rules and to take actions to correct noncompliant behavior. The TDI-DWC assesses the performance of insurance carriers and
health care providers as a part of a biannual Performance Based Oversight (PBO) assessment.
Of the 99 health care providers reviewed for the timeliness of filing the Report of Medical Evaluation, 87 health care providers had
scores placing them in the high performer tier, 10 health care providers were in the average performer tier, and 2 health care providers had
scores placing them in the poor performer tier.
Of the 100 health care providers reviewed for the timely release to return to work and completeness of the Work Status Report, 49
health care providers had scores placing them in the high performer tier, 34 health care providers were in the average performer tier, and
17 health care providers had scores placing them in the poor performer tier.
Of the 41 health care providers reviewed for the usage of magnetic resonance imaging, 32 health care providers had scores placing them in
the high performer tier, 9 health care providers were in the average performer tier, and no health care providers had scores placing them in
the poor performer tier. This category was a pilot measure and individual results will not be made public.
The TDI-DWC uses Performance Based Oversight, data monitoring, complaint handling, audits, enforcement actions and referrals to law
enforcement, when appropriate, to achieve its compliance objectives. The TDI-DWC will focus its regulatory oversight on the poor
performers while offering incentives for high performers in order to promote improved performance and greater overall compliance with
the Workers’ Compensation Act and TDI-DWC rules.
The results of the 2011 PBO assessment and a list of the health care providers assessed are posted on the TDI website. The omission of
a health care provider from the list does not imply that a health care provider participating in the Texas workers’ compensation system
is exempt from the requirement to comply with the Workers’ Compensation Act and TDI-DWC rules.
Further information regarding PBO and the 2011 assessments may be found on the TDI website at http://www.tdi.texas.
gov/wc/pbo/hcppbo.html.
| TEXAS WORKERS COMPENSATION COLLECTION PUBLICATIONS AND INFORMATION FOR MEDICAL PROVIDERS |
Copyright © 2011 Workcompliens.com All rights reserved
 |  |  |  |  |
