Office of the Medical Advisor
Texas Labor Code (TLC) sections 413.0511 and 413.0512 require the Texas Department of Insurance, Division of Workers' Compensation (TDI-DWC) to review the quality of health care provided in the workers' compensation system and take appropriate action as needed. In addition to reviewing health care providers that deliver services, TLC also requires TDI-DWC to review actions of peer review doctors, designated doctors, utilization review agents, and independent review organizations.
The Medical Advisor advises TDI-DWC regarding the adoption of rules and policies. The Medical Advisor reviews complaints on quality of care received through the Complaint Resolution and Customer Services section and serves as chair of the Medical Quality Review Panel (MQRP). The panel reviews the actions of doctors, other health care providers, insurance carriers, utilization review agents, and independent review organizations in the workers' compensation system.
- Mary Landrum, Director - 512-804-4814
- Karen Weinstein, R.N. - 512-804-4297
- Kathy Ellis, R.N. - 512-804-4847
- Teresa Barajas, R.N. - 512-804-4851
- The TDI-DWC is seeking qualified individuals to provide professional services as a member of the MQRP. To apply please refer to Texas Administrative Code section 180.64 MQRP Application Process. You can access the rule at http://www.tdi.texas.gov/wc/rules/adopted/index.html. The MQRP application form (DWC072) can be found at http://www.tdi.texas.gov/forms/dwc/dwc072mqrpapp.pdf.
- Medical Quality Review Process Document Effective May 1, 2014 | memo
- Medical Quality Review Procedure effective January 1, 2011
- Medical Quality Review CY 2014 Annual Audit Plan | memo
- Medical Quality Review CY 2013 Annual Audit Plan | memo
- Medical Quality Review CY 2012 Annual Audit Plan | memo
- Medical Quality Review Annual Audit Plan effective January 1, 2011
- December 2011 Utilization Review Agent Plan-Based Audit | memo
- September 2011 Treating Doctors - Lumbar Spinal Fusions Plan-Based Audit | memo (PDF)
- May 2011 Designated Doctor Plan-Based Audit (April 2010 Designated Doctor Review, Follow-Up Audit) | memo (PDF)
- February 2011 IRO Plan-Based Audit | memo (PDF)
- Medical Quality Review Selection Criteria CY 2010
- Designated Doctor Resources
- Disciplinary Orders Against Health Care Providers
- Providing Health Care to Injured Employees
David G. Davis, M.D. became the DWC Medical Advisor, effective August 26, 2013. He has served as a member of the DWC Medical Quality Review Panel (MQRP) as a case reviewer, participated in informal settlement conferences, attended quarterly arbiter meetings, provided MQRP training and assisted in the development of plan-based audits. Dr. Davis has also reviewed designated doctor applications for certification and recertification and assisted with designated doctor questions. He has participated in the designated doctor program since 2004.
Dr. Davis has more than 35 years of experience in orthopedic surgery, hand surgery, orthopedic reconstructive surgery and sports medicine. He retired from his 20 year Austin-based practice in 2012. Previously, he practiced as an orthopedic surgeon in California from 1979 to 1992, and is a member of the American Academy of Orthopaedic Surgeons. Dr. Davis attended medical school at the University of Texas Medical School at San Antonio and received additional Orthopedic Surgery training at Loma Linda University Medical Center in Loma Linda, California.
Edwin R. Buster III, MD joined the TDI-DWC as an Associate Medical Advisor in September 2010. From 1970 to May 2011, Dr. Buster was in private practice at Capital Neurosurgical Association in Austin. Currently he is a Diplomate of the American Board of Neurological Surgery and a former Medical Consultant to the Texas Medical Board. He is also a member of American Medical Association, Travis County Medical Society, Texas Association of Neurological Surgeons, American Association of Neurological Surgeons and Austin Neurological Society.
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Last updated: 09/06/2014