Texas Workers’ Comp Division Releases Health Care Provider Oversight Results for 2021

This week the Texas Division of Insurance coverage, Division of Employees’ Compensation (DWC) launched the 2021 Well being Care Supplier Efficiency Based mostly Oversight (PBO) evaluation.

Well being care suppliers had been assessed on their performances in considered one of two classes:

• DWC Kind-069, Report of Medical Analysis class
• DWC Kind-073, Work Standing Report class.

2021 was the primary PBO biking utilizing the brand new methodology combining the 2 DWC Kind-073, Work Standing Report measures into one rating.

DWC reviewed 96 well being care suppliers for the timeliness of submitting the DWC Kind-069, Report of Medical Analysis (100% weight) with the next outcomes: 66 had scores putting them within the excessive performer tier, 15 had been within the common performer tier, and 15 had scores putting them within the poor performer tier.

DWC reviewed 91 well being care suppliers for the completeness of the DWC Kind-073, Work Standing Report (30% weight) and documentation supporting how the injured worker’s medical situation prevents them from returning to (any) work as reported on the DWC Kind-073, Work Standing Report (70% weight) with the next outcomes: 45 had scores putting them within the excessive performer tier, 38 had been within the common performer tier, and eight had scores putting them within the poor performer tier.

The 2021 PBO evaluation outcomes and an inventory of the well being care suppliers that had been reviewed are posted on the TDI website. If a well being care supplier will not be listed, they weren’t assessed in 2021; nonetheless, no well being care supplier within the Texas staff’ compensation system is exempt from compliance with the Texas Labor Code and DWC guidelines.

Extra data on PBO and the 2021 evaluation can be found on the TDI website.

Supply: DWI-TWC

Subjects
Texas
Workers’ Compensation
Medical Professional Liability