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You are here: www.tdi.texas.gov . news . 2011 . news201113
Archived File - for Reference Use

This file is historical in nature. Links and contact information may be outdated and no longer valid.


April 15, 2011

Division of Workers' Compensation Announces March Enforcement Actions

AUSTIN - Commissioner of Workers' Compensation Rod Bordelon recently announced final disciplinary actions taken by the Texas Department of Insurance, Division of Workers' Compensation (TDI-DWC). The final actions include orders related to violations of the Texas Labor Code and rules promulgated by the Commissioner of Workers' Compensation.

Copies of Commissioner of Workers' Compensation orders may be obtained by calling Maria Jimenez, TDI-DWC Enforcement, at 512-804-4703 or via e-mail to Maria.Jimenez@tdi.state.tx.us.

DIVISION OF WORKERS' COMPENSATION

FINAL DISCIPLINARY ORDERS FOR MARCH 2011 (alphabetical order)

Ace American Insurance Company of Philadelphia, PA
Order Number: DWC-11-0028
Date of Order: 3/3/2011
Order Final In: March
Action Taken: Nunc Pro Tunc
Violation: Please see Order Number DWC 11-0011

American Home Assurance Company of New York NY
Order Number: DWC-11-0032
Date of Order: 3/3/2011
Order Final In: March
Action Taken: Fined $11,000
Violation: Failed to pay for preauthorized medical services; Failed to timely respond to an injured employee's request for reimbursement of travel expenses

Arch Insurance Company of Jersey City, NJ
Order Number: DWC-110030
Date of Order: 3/3/2011
Order Final In: March
Action Taken: Fined $4,500
Violation: Failed to timely pay income benefits to injured employee; Failed to timely pay medical bill; Failed to timely act on request for reconsideration of a medical bill

Begia, Bruce C., M.D. of San Antonio
Order Number: DWC110040
Date of Order: 3/11/2011
Order Final In: March
Action Taken: Fined $1,000; Must attend compliance training for doctors and medical staff
Violation: Failed to timely file and/or accurately complete TDI-DWC forms, reports or records

Bumagin, Michael S. M.D. of Fort Worth
Order Number: DWC110027
Date of Order: 3/3/2011
Order Final In: March
Action Taken: Removed from Designated Doctor List; Maximum Medical Improvement and Impairment Rating certifications revoked
Violation: Failed to assign Impairment Ratings in accordance with the American Medical Association Guides to Permanent Impairment

Crockett, James D.O. of Marlin
Order Number: DWC110043
Date of Order: 3/24/2011
Order Final In: March
Action Taken: Removed from participation in workers' compensation system as health care provider for 10 years
Violation: Provided diagnoses and treatments found to be improper, unfair and/or unreasonable and not supported by documentation and/or physical examination of injured employee

Dallas National Insurance Company, A Texas Stock Insurance Company of Dallas
Order Number: DWC-110042
Date of Order: 3/22/2011
Order Final In: March
Action Taken: Fined $9,000
Violation: Failed to pay for preauthorized medical services; Failed to timely pay income benefits to injured employee

Davis, Carl Cuthbert Jr., M.D. of Houston
Order Number: DWC110031
Date of Order: 3/3/2011
Order Final In: March
Action Taken: Fined $1,250; Suspended from Designated Doctor's List of 90 days; Must attend compliance training for doctors and medical staff
Violation: Failed to timely file letter of clarification; Failed to timely file and/or accurately complete TDI-DWC forms, reports or records

Hartford Fire Insurance Company of Hartford, CT
Order Number: DWC-110035
Date of Order: 3/3/2011
Order Final In: March
Action Taken: Fined $5,000
Violation: Failed to reasonably and prudently process claims ; Failed to provide written notification of claims experience; Failed to provide written notification of loss analysis; Failed to provide mandatory on-site visit to policyholders

Hartford Insurance Company of the Midwest of Hartford, CT
Order Number: DWC110034
Date of Order: 3/3/2011
Order Final In: March
Action Taken: Fined $4,500
Violation: Failed to timely pay income benefits to injured employee; Failed to provide written notification of claims experience

Horoda, Michael Johnathan, M.D. of Fort Worth
Order Number: DWC110029
Date of Order: 3/3/2011
Order Final In: March
Action Taken: Fined $3,000
Violation: Failed to timely file and/or accurately complete TDI-DWC forms, reports or records

Houston Northwest Emergency Specialists, PLLC of Houston
Order Number: DWC110039
Date of Order: 3/7/2011
Order Final In: March
Action Taken: Fined $4,000
Violation: Improperly billed an injured employee for workers' compensation medical services provided

Moczygemba, Roger M., M.D. of San Antonio
Order Number: DWC-110041
Date of Order: 3/22/2011
Order Final In: March
Action Taken: Fined $3,000; Must attend compliance training for doctors and medical staff
Violation: Failed to timely file and/or accurately complete TDI-DWC forms, reports or records

Osborne, William (Phillip) M.D. of Houston
Order Number: DWC-110044
Date of Order: 3/24/2011
Order Final In: March
Action Taken: Fined $4,500; Must attend compliance training for doctors and medical staff
Violation: Failed to timely file and/or accurately complete TDI-DWC forms, reports or records

TASB Risk Management Fund of Austin
Order Number: DWC110036
Date of Order: 3/3/2011
Order Final In: March
Action Taken: Fined $5,000
Violation: Failed to timely pay income benefits to injured employee

Transportation Insurance Company of Chicago, IL
Order Number: DWC-110033
Date of Order: 3/3/2011
Order Final In: March
Action Taken: Fined $10,000
Violation: Retrospectively reviewed medical necessity of preauthorized medical service or treatment; Failed to pay for preauthorized medical services

Wan, Christine Wyman M.D. of Odessa
Order Number: DWC110037
Date of Order: 3/3/2011
Order Final In: March
Action Taken: Fined $1,000; Must attend compliance training for doctors and medical staff
Violation: Failed to timely file and/or accurately complete TDI-DWC forms, reports or records

Wolski, Edward, M.D. DBA Wol+Med of Denton
Order Number: DWC110038
Date of Order: 3/7/2011
Order Final In: March
Action Taken: Fined $5,000
Violation: Filed unwarranted complaints against system participants



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Last updated: 09/07/2014

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