Latest News | Professional Associates

Basic Workers’ Compensation for Medical Office Staff Seminar Offered in Houston on June 8

05/20/11

AUSTIN, TX — The Lone Star College System (LSCS) Small Business Development Center (SBDC) will sponsor an educational seminar for medical office staff, including office managers and billing staff, entitled Basic Workers’ Compensation for Medical Office Staff on Wednesday, June 8, 2011. The seminar is presented by the Texas Department of Insurance, Division of Workers’ Compensation. The seminar will be held from 9 a.m. to 4 p.m. at Lone Star College-North Harris, Room ACAD 126, 2700 W.W. Thorne Drive in Houston. The fee is $99 per person and includes lunch.

What is Workers' Compensation?

05/20/11

Workers' compensation is a state-regulated insurance program that pays medical bills and replaces some lost wages for employees who are injured at work or who have work-related diseases or illnesses. Workers' compensation will pay for the medical treatment of an injury or illness if:

Renewal of Emergency Adoption: Amended 28 TAC §134.503 Regarding the Pharmacy Fee Guideline

05/20/11

The Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC) has submitted a Renewal of Effectiveness for the emergency adoption of amended 28 Texas Administrative Code (TAC) §134.503 regarding the Pharmacy Fee Guideline. The text of the amended section was originally published in the December 31, 2010, issue of the Texas Register (35 TexReg 11777).

Requests for a Letter of Clarification (LOC) of a Designated Doctor’s Report

05/20/11

Pursuant to 28 Texas Administrative Code (TAC) §127.20(a), an insurance carrier, injured employee, or the injured employee’s representative may file a request for a Letter of Clarification regarding a designated doctor’s report with the Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC). Parties may only request clarification on issues addressed by the designated doctor’s report or on issues that the designated doctor was ordered to address, but did not address in his/her report.

HWCN NEWS - IRO PROCESS

10/06/10

The HWCN Division receives a high volume of telephone calls from patients and health careproviders asking how to obtain an IRO review, where to send an IRO request, how much will theIRO cost and who will pay for the IRO, how long does the review take and questions about theIRO process.Is the denial eligible for IRO review?IROs are independent entities that are certified by TDI to review adverse determinations forhealth, WC non-network and WCNet coverages. An adverse determination is a determination by

HMO Emergency Services Reimbursement

10/06/10

TDI receives numerous complaints from out-of network

Federal Health Care Reform - TDI Activities

10/06/10

Federal Health CareReform–TDI ActivitiesThe Patient Protection and Affordable Care Act(PPACA), referred to by many as “Federal HealthCare Reform” has usextremely busy.Staff members from several of TDI’s programareas are working to identify what changes tostatutes and rules will be necessary to implementthe new requirements.Some of PPACA’s provisions are set to take effectin 2010, while others will be phased in through2020.

Rate of Nonfatal Occupational Injuries and Illnesses in Texas Declined in 2008

11/05/09

Public Sector Data Included for First Time in Annual Survey of Occupational Injuries and Illnesses AUSTIN, TX - Private industry workplaces in Texas reported a total of 234,559 nonfatal injuries and illnesses during 2008. The incidence rate of 3.1 cases per 100 equivalent full-time workers marks the sixth consecutive year that the incidence rate has dropped. The rate for 2008 is a 9% decrease from 3.4 in 2007. The Texas rate is below the national rate of 3.9 for 2008.

TX - Study Examines ODG Impact on Comp System Claims

10/01/09

By Bill Kidd, Central Bureau Chief billkidd@texas.net The Texas Department of Insurance has issued a preliminary report examining how using the Official Disability Guidelines in the state’s workers’ compensation system has affected both medical costs and utilization which indicates significant improvement in recent years. The report says that from 2005 to 2008, the number of claims decreased by 8%, total cost of claims dropped 24%, and the average claim cost declined 17%.

08/31/09

AUSTIN, TX - Texas recorded 457 work-related fatalities in 2008, a 13 percent decrease compared to 2007 when 528 fatalities occurred. Nationally, there were 5,071 fatal work injuries in 2008, a decrease of 20 percent from the revised total of 5,657 in 2007, according to the most recently available data released August 20, 2009, by the U.S. Department of Labor, Bureau of Labor Statistics (BLS), Census of Fatal Occupational Injuries (CFOI).