Austin, TX – Commissioner of Workers’ Compensation, Ryan Brannan, recently announced final disciplinary actions taken by the Division of Workers’ Compensation (DWC).
The final actions include administrative penalties ordered against insurance carriers and health care providers in the workers’ compensation system. Beginning January 1, 2015, through March 31, 2015, the Commissioner of Workers’ Compensation has ordered administrative penalties totaling $440,500 for system participants. The penalties include $391,300 in fines ordered for insurance carriers, $29,200 in fines ordered for health care providers, and $20,000 in fines ordered for other entities.
Violations of the Texas Labor Code by insurance carriers cited in recent orders include failure to timely pay benefits ordered to an injured employee, and failure to timely take action on a medical bill. Violations cited in orders naming health care providers include failure to timely file and/or accurately complete DWC forms, reports or records, and improper billing of medical services to an injured employee.
Summaries of the actions:
American Zurich Insurance Company of Schaumburg, IL
Order Number: 3857
Date of Order: 3/11/2015
Action Taken: Fined $3,000
Violation: Failed to take final action on a complete medical bill
Atkins, Ernie Lee D.O. of San Antonio
Order Number: 3868
Date of Order: 3/23/2015
Action Taken: Fined $4,000
Violation: Failed to timely provide designated doctor with injured employee’s medical records; Failed to timely comply with a division order to produce documents
Carter, Jerome Oliver M.D. of Houston
Order Number: 3867
Date of Order: 3/20/2015
Action Taken: Fined $3,000
Violation: Failed to comply with Commissioner rule; Failed to timely respond to request for clarification
Radiology Associates of North Texas of Fort Worth
Order Number: 3879
Date of Order: 3/30/2015
Action Taken: Fined $4,000
Violation: Improperly billed an injured employee for workers’ compensation medical services provided
Rochdale Insurance Company of New York, NY
Order Number: 3856
Date of Order: 3/11/2015
Action Taken: Fined $1,600
Violation: Failed to timely comply with order for advance payment of income benefits
Source: TDI-DWC