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Chiropractors meeting notes- December 2009
TCA: Dr. Kevin Kanz, Patte Kent, Chip Kent
TDI: Audrey Selden, Valerie Brown, Melissa Hield (Consumer Protection), Pat Brewer (Health and Workers' Compensation Networks), Amy Rich, Denny Whitehouse (DWC), Dennis Pompa (Fraud)
Legislative Update: Pat Brewer provided an update on implementation of some legislation of interest:
- HB 2064 - changed the prompt payment penalty calculations; interest payments will fund low-income applicants to the Texas Health Insurance Pool
- TDI has published rules regarding Healthy Texas
- HB 4290 - changes utilization review requirements; rules are being drafted; the rules will apply to DWC claims as well
Amy Rich, DWC Provider Ombudsman, urged providers to participate in the DWC rule comment process. Information about proposed rules is posted on DWC's website at www.tdi.state.tx.us/wc/indexwc.html and www.tdi.state.tx.us/wc/rules/index.html. An important change is that providers must go through the benefit review process. The case management rule formal comments are being accepted until 12/11; these rules will define the certifications for a case manager. Informal comments are requested on the e-billing rules; there will be a provision for a waiver.
Other key resources for WC providers are:
- DWC Comp Connection for health care providers with billing reimbursement or dispute resolution questions: 1-800-372-7713 option #3
- DWC e-mail for health care providers: firstname.lastname@example.org
- For DWC events and training: www.tdi.state.tx.us/wc/events/index.html
Dr. Kanz said he has been promoting DWC's web tools as great resources for chiropractors. Amy is also giving several one-day training sessions around the state for providers and staff; she can also provide training "on-line" via a webinar.
Dr. Kanz reported that he recently treated a new patient who had been to 11 doctors who did not accept WC patients before he came to Dr. Kanz. There was further delay while waiting for approval of the treatment plan. Amy agreed that access to care is a priority issue, and DWC is hiring more staff in order to assist providers.
Complaints: Valerie Brown noted that in calendar year 2009, TDI-Consumer Protection received 91 complaints from chiropractors, an increase over prior years: 27 in 2008, and 7 in 2007. Top reasons for complaints are delays and unsatisfactory settlements.
Denny Whitehouse reported on WC complaints. In 2009 DWC has received 65 complaints from chiropractors; top reasons included insufficient reason for denial and not following fee guidelines.
Outreach: Patte Kent said the Mid-Winter conference is set for February 26-28 in Fort Worth and TDI will have an exhibit. The annual convention will be in June.
Fraud update: Dennis Pompa reported that HB 148 prohibiting release of vehicle accident reports for 30 days is being challenged in federal court and is pending the judge's ruling. At an August hearing, the Texas Department of Transportation ruled to remove the accident victim's phone number from the police report as of January 2010. TDI and TCA wrote letters supporting this change. FYI, the TDI Fraud Unit's annual report will be available in January on TDI's website at www.tdi.state.tx.us/fraud/index.html.
Next Meeting: We agreed to continue our quarterly meetings in 2010. Please see dates below; meetings begin at 2 p.m. and are via conference call:
- March 4, 2010
- June 3, 2010
- September 2, 2010
- December 2, 2010
For more information contact:
Last updated: 10/05/2015