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TX DWC Announces Enforcement Actions For February 2009

20 Mar, 2009 WorkersCompensation.com

                               
Austin, TX (CompNewsNetwork) - Commissioner of Workers' Compensation Rod Bordelon recently announced final disciplinary actions taken by the Texas Department of Insurance, Division of Workers' Compensation (TDI-DWC) in February 2009. The final actions include orders assessing administrative penalties totaling $152,500 for violations of the Texas Labor Code and rules promulgated by the Commissioner of Workers' Compensation.  Commissioner's orders are subject to appeal to state district court within 30 days after being issued.

Final Disciplinary Orders For Feb. 2009

Continental Casualty Company of Chicago, IL
Order No.: DWC-09-0015
Date of Order: February 27, 2009
Action Taken: Fined $55,000
Violation(s): Inappropriate payment or denial of payment of 144 medical bills out of 517 bills reviewed; failure to meet compliance standard for data submission accuracy, timely reporting of medical bill data, or timely processing of medical bills.

Dewitt C. Fortenberry, M.D. of Texarkana
Order No.: DWC-09-0012
Date of Order: February 25, 2009
Action Taken: Fined $1,500
Violation(s): Failure to file Report of Medical Evaluation in a timely manner.

National Fire Insurance Company of Chicago, IL
Order No.: DWC-09-0016
Date of Order: February 27, 2009
Action Taken: Fined $12,000
Violation(s): Inappropriate payment or denial or payment of  41 medical bills out of 205 bills reviewed; failure to meet compliance standard for appropriate denial or reduction of a medical bill.

St. Luke's Episcopal Health System of Houston
Order No.: DWC-09-0011
Date of Order: February 25, 2009
Action Taken: Fined $1,000
Violation(s): Improperly pursuing a private claim against a workers' compensation claimant when the injury had not been finally adjudicated and the claimant had not been in violation of their selection of a doctor.

Transcontinental Insurance Company of Chicago, IL
Order No.: DWC-09-0014
Date of Order: February 27, 2009
Action Taken:  Fined $18,000
Violation(s): Inappropriate payment or denial of payment of 90 medical bills out of 318 medical bills reviewed; failure to meet the compliance standard for appropriate denial or reduction of a medical bill.

Transportation Insurance Company of Chicago, IL
Order No.: DWC-09-0013
Date of Order: February 27, 2009
Action Taken: Fined $65,000
Violation(s): Inappropriate payment or denial of payment of 154 medical bills out of 422 medical bills reviewed; failure to meet the compliance standard for appropriate denial or reduction of a medical bill. 

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