Texas: Performance Based Oversight

Texas: Performance Based Oversight

Stuart Colburn   By Stuart D. Colburn, Esq., Shareholder, Downs Stanford

The Division held its first Performance Based Oversight (PBO) working group meeting on July 27, 2011.  The meeting notes developed by the Division of Workers’ Compensation are attached to this Advisory.  I refer you to those notes for a discussion of what took place at this meeting.

Performance Based Oversight was mandated by the Legislature to promote the study of healthcare providers and insurance carriers.  Insurance carriers have undergone three evaluations and the fourth is planned in 2012.

The Division solicits additional criteria to evaluate insurance carriers.  The insurance carrier community has agreed to look at the possibility of other criteria.  We have asked the Division to supply information to all stake holders including what data is currently being gathered and what could be gathered.

New members of the PBO working group raised the possibility of adding criteria that had previously been considered and determined not feasible by the working group.  The Division believes that if new criteria are discussed, perhaps there are additional ways of securing the same or similar information.

Two new criteria were briefly discussed.  Carriers could be evaluated on whether they provide accident prevention services and return to work coordination services.  However, not every carrier is required by statute to provide these services.

I recommended to the Division that they establish a set of protocol or standards when determining if a certain criteria is warranted.  I suggested the following:

  Is it measurable?

  Is it significant (does it mean something?)

  Are resources available (DWC, HCP, and IC)?

The next meeting is scheduled for August 10, 2011 at 1:30 p.m.  If you would like Downs Stanford to submit any additional information or comments on your behalf, please contact me at (512) 751-6017 or scolburn@downsstanford.com.

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