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Austin, TX (CompNewsNetwork) - The Texas Department of Insurance, Division of Workers' Compensation (TDI-DWC) seeks input and suggestions regarding the development of a new Medical Quality Review Audit Plan (Audit Plan). The Audit Plan sets the priorities for what types of audits the Medical Quality Review Panel will focus on for the next year. A copy of the current Audit Plan can be viewed at:
http://www.tdi.state.tx.us/wc/hcprovider/documents/mqrplan.pdf.
http://www.tdi.state.tx.us/wc/hcprovider/documents/mqrplan.pdf.
The Medical Advisor is responsible for developing the Audit Plan, which will be adopted by the Commissioner of Workers' Compensation. The Medical Advisor will evaluate Audit Plan suggestions from system participants using the following criteria:
• Does the suggested audit relate to a statutory responsibility of the Medical Advisor or the Medical Quality Review Panel pursuant to Sections 413.0511 and 413.0512, Texas Labor Code? (e.g., the quality of health care provided by doctors or other health care providers treating injured employees or the quality and timeliness of decisions made by utilization review agents, insurance carriers, designated doctors or Independent Review Organizations)
• Does TDI-DWC have the available administrative data to select system participants for the audit or can data be obtained easily and economically to complete the audit?
• Does TDI-DWC have sufficient resources to complete the audit within the next year? Workers' compensation system participants should submit suggestions for the Audit Plan via email to OMA.atlas.TDI@tdi.state.tx.us by 5 p.m. Central Standard Time on Tuesday, December 14, 2010. Comments and input can also be provided at the December 14, 2010 stakeholder meeting, which starts at 1 p.m. in the Tippy Foster Room at the TDI-DWC Central Office, 7551 Metro Center Drive, Suite 100 in Austin.
• Does the suggested audit relate to a statutory responsibility of the Medical Advisor or the Medical Quality Review Panel pursuant to Sections 413.0511 and 413.0512, Texas Labor Code? (e.g., the quality of health care provided by doctors or other health care providers treating injured employees or the quality and timeliness of decisions made by utilization review agents, insurance carriers, designated doctors or Independent Review Organizations)
• Does TDI-DWC have the available administrative data to select system participants for the audit or can data be obtained easily and economically to complete the audit?
• Does TDI-DWC have sufficient resources to complete the audit within the next year? Workers' compensation system participants should submit suggestions for the Audit Plan via email to OMA.atlas.TDI@tdi.state.tx.us by 5 p.m. Central Standard Time on Tuesday, December 14, 2010. Comments and input can also be provided at the December 14, 2010 stakeholder meeting, which starts at 1 p.m. in the Tippy Foster Room at the TDI-DWC Central Office, 7551 Metro Center Drive, Suite 100 in Austin.
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