Texas Administrative Code
Title 28 - INSURANCE
Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION
Chapter 180 - MONITORING AND ENFORCEMENT
Subchapter C - MEDICAL QUALITY REVIEW PANEL
Section 180.68 - Medical Quality Review Process
Universal Citation: 28 TX Admin Code ยง 180.68
Current through Reg. 49, No. 38; September 20, 2024
(a) The medical quality review process is medical case review initiated on the basis of complaints, plan-based audits, or monitoring as a result of a consent order and performed in accordance with criteria adopted under Labor Code § 413.05115. The medical quality review process does not include medical case review performed for the purpose of:
(1) certification and renewal of
designated doctors;
(2)
performance-based oversight;
(3)
administrative violations that do not require an expert medical opinion;
or
(4) complaints about
professionalism that do not require an expert medical opinion.
(b) A complaint must be documented in accordance with the provisions of § 180.2 of this title (relating to Filing a Complaint).
(c) Nothing in this subchapter prevents referrals of complaints to another licensing or law enforcement authority.
Disclaimer: These regulations may not be the most recent version. Texas may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.
