Authorities in the Lone Star State continue to stay on top of any fraudulent issues regarding the workers compensation industry.
Commissioner of Workers Compensation, Ryan Brannan, recently announced final disciplinary actions taken by the Division of Workers Compensation (DWC).
The final actions include administrative penalties ordered against insurance carriers, health care providers and other entities in the workers comp system.
Beginning Jan. 1, 2015, through Feb. 28, 2015, the Commissioner of Workers Compensation has ordered administrative penalties totaling $424,900 for system participants. The penalties include $386,700 in fines ordered for insurance carriers, $18,200 in fines ordered for health care providers, and $20,000 in fines ordered for other entities.
Violations of the Texas Labor Code by insurance carriers cited in recent orders include failure to timely initiate and pay benefits to an injured employee, failure to accurately calculate benefits owed to an injured employee, failure to timely notify TDI-DWC of action taken on a claim, and failure to timely and accurately submit medical data.
Violations cited in orders naming health care providers include failure to follow proper medical treatment guidelines, administering unreasonable or medically unnecessary treatment or services, and failure to timely file and/or accurately complete DWC forms, reports or records.
Violations cited in orders naming other entities include issuing medical necessity denials without allowing health care providers a reasonable opportunity to discuss them with a medical doctor.
Summaries of disciplinary actions are available on the TDI website at: https://wwwapps.tdi.state.tx.us/inter/asproot/commish/da/dwcclips2015.asp
Author Kori Shafer-Stack, Editor, Amaxx Risk Solutions, Inc. is an expert in post-injury response procedures and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. www.reduceyourworkerscomp.com. Contact: kstack@reduceyourworkerscomp.com.
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