Texas Performance Based Oversight Work Group Meeting Study

Texas Performance Based Oversight Work Group Meeting Study

The Division conducted its second Performance Based Oversight (PBO) work group meeting.  Stakeholders discussed various measures to assess the performance of insurance carriers.  Although options were discussed, the Division may keep the same four measures from the previous study.  Those measures are as follows: timely initial payment of temporary income benefits, timely EDI reporting of initial pay of temporary income benefits, timely payment of medical bills, and timely medical EDI transaction reporting.  The Division is not ready to discuss the bell curve.  Carriers successfully argued in 2007 the Bell Curve unfairly punished workers' compensation carriers.

The Division may alternate evaluation of carriers and healthcare providers.  Currently, healthcare providers and carriers are judged every two years as required by statute.  The Division is considering making an assessment of carriers in 2010 followed by healthcare providers in 2011.  If the Division makes this change, they will utilize data from January 2010 through July 2010.  Carriers should ensure their current date and payments are both timely and accurate.