Current through Reg. 49, No. 38; September 20, 2024
(a) To
apply to the MQRP, a person must submit an application in the form and manner
required by the division demonstrating compliance with the required
qualifications. The application must contain complete information as provided
by subsection (b) of this section. The medical advisor and the Commissioner may
select and appoint only qualified applicants to the division's MQRP but are not
required to accept all applicants who meet the requirements specified in this
subchapter.
(b) The division's
required application form for the MQRP, at a minimum, shall include:
(1) contact information for the health care
practitioner;
(2) information about
the health care practitioner's education;
(3) a description of the health care
practitioner's license(s), certifications, and professional specialty, if
any;
(4) a description of the
health care practitioner's work history and hospital or other health care
practitioner affiliations;
(5) a
description of any affiliations the health care practitioner has with a
workers' compensation health care network certified under Chapter 1305 of the
Insurance Code or a political subdivision as described in Labor Code §
504.053(b)(2);
(6) identification of and a description of
all current and past medical review affiliations, including but not limited to
an independent review organization (IRO), utilization review agent (URA),
licensing board, and insurance carrier;
(7) information regarding the health care
practitioner's current practice locations;
(8) disclosure regarding the health care
practitioner's professional background, education, training, and fitness to
perform the duties of an MQRP member, including disclosure of any disciplinary
actions or other sanctions taken against the health care practitioner by any
state licensing board, state or federal agency, and hospital or other health
care institution, as well as disclosure of any voluntary relinquishments, drug
and alcohol misuse, malpractice claims history and criminal history;
(9) a description of all ownership interests
or other financial arrangements, such as salaried or contract employment,
involving a person or their agent subject to the Act or a rule, order, or
decision of the commissioner;
(10)
an authorization for third parties to release information relevant to the
verification of the information provided on the application to the
division;
(11) an affirmation that
all information provided in the application is accurate and complete to the
best of the health care practitioner's knowledge; and
(12) an affirmation of understanding of the
legal requirements, including confidentiality provisions, for MQRP
members.
(c) A
credentialing application for hospital credentialing may substitute for some
items under subsection (b) of this section.
(d) The health care practitioner must inform
the medical advisor of any changes to this information within 30 days after the
change.
(e) The application shall
be reviewed by the medical advisor.
(f) The medical advisor and the commissioner
have the discretion to select, appoint and remove an applicant to the
MQRP.
(g) Membership in the MQRP is
for a term of 10 years. The acceptance letter will include the effective date
and expiration date.
(h) Membership
in the MQRP is not a guarantee of any number of assignments.
(i) MQRP members shall be entitled to
compensation for work assigned by the medical advisor at the following hourly
rates:
(1) Doctors - Medical case reviews, ad
hoc work groups, or special projects: $150 per hour.
(2) Non-Doctors - Medical case reviews, ad
hoc work groups or special projects: $100 per hour.
(3) Limits on hours. A member shall not be
paid for more than:
(A) five hours for a
medical case review of a single case;
(B) five hours for ad hoc work group or
special project service; or
(C) 20
hours in a given calendar month.
(4) The medical advisor may approve
additional hours in writing upon review of a submitted narrative report or a
report of an ad hoc work group.
(5)
Hearings or trial preparation.
(A) Doctors -
Payment for time spent in hearing or in trial preparation, in providing
testimony in deposition, hearing or trial: $350 per hour.
(B) Non-doctors - Payment for time spent in
hearing or in trial preparation, in providing testimony in deposition, hearing
or trial: $175 per hour.
(C) An
MQRP member shall not be paid for more than eight hours per day for a
deposition, a hearing, trial preparation or court testimony. If travel is
required, the division will pay the member for travel, lodging and per diem
expenses in accordance with the Texas State Travel Management Program, 34 TAC
§20.301 et
seq.
(6) The division may
vary the above reimbursement provisions if deemed by the division to be in the
best interests of the division or the State of Texas.
(j) In accordance with Labor Code
§§
402.083
-
402.086,
402.091, 402.092, and 413.0513, an MQRP member may not disclose confidential
information, including a report or other documentation prepared by the MQRP
member for the division.
(k) All
reports and related documents, including electronic and non-electronic data,
prepared by or furnished to the member for the MQRP, are the sole property of
the division.
