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

This week the Texas Department of Insurance, Division of Workers’ Compensation (DWC) released the 2021 Health Care Provider Performance Based Oversight (PBO) assessment.

Health care providers were assessed on their performances in one of two categories:

• DWC Form-069, Report of Medical Evaluation category
• DWC Form-073, Work Status Report category.

2021 was the first PBO cycling using the new methodology combining the two DWC Form-073, Work Status Report measures into one score.

DWC reviewed 96 health care providers for the timeliness of filing the DWC Form-069, Report of Medical Evaluation (100% weight) with the following results: 66 had scores placing them in the high performer tier, 15 were in the average performer tier, and 15 had scores placing them in the poor performer tier.

DWC reviewed 91 health care providers for the completeness of the DWC Form-073, Work Status Report (30% weight) and documentation supporting how the injured employee’s medical condition prevents them from returning to (any) work as reported on the DWC Form-073, Work Status Report (70% weight) with the following results: 45 had scores placing them in the high performer tier, 38 were in the average performer tier, and 8 had scores placing them in the poor performer tier.

The 2021 PBO assessment results and a list of the health care providers that were reviewed are posted on the TDI website. If a health care provider is not listed, they were not assessed in 2021; however, no health care provider in the Texas workers’ compensation system is exempt from compliance with the Texas Labor Code and DWC rules.

More information on PBO and the 2021 assessment are available on the TDI website.

Source: DWI-TWC

Topics Texas Workers' Compensation