Austin, TX – The Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC) recently announced that it has published the 2027 Health Care Provider Performance-Based Oversight Assessment Plan.
The DWC regularly evaluates the performance of workers’ compensation health care providers (providers) in selected areas of compliance through Performance Based Oversight assessments. See Texas Labor Code §402.075.
The purpose of PBO is to:
- Set performance expectations
- Reward excellence
- Encourage continuous improvement
There are two separate categories of review. Each has its own measures and selection criteria.
Providers may be selected for one or both categories based on the selection criteria.
Categories and measures
- DWC Form-73 Work Status Report billed by MD, DO, DC, APRN, and PA
- Is form complete or incomplete per Rule 129.5?
- Is the “off work” status in Part II. supported?
- DWC Form-69 Report of Medical Evaluation filed to DWC by Designated Doctors
- Was the report filed to DWC on time or late per Rule 130.1(d)(2) and any other rules that extend the deadline?
The DWC places providers in a high, average, or poor regulatory tier for each category based on the
outcome.
View the full plan: TDI-DWC 2027 Health Care Provider Performance-Based Oversight Assessment Plan (PDF)
Source: TDI-DWC