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 in August, 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 and chaired 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, assisted with designated doctor training and testing, as well as previously directly participated as a designated doctor. Dr. Davis has more than 35 years of experience in orthopedic surgery, retiring from his clinical Austin-based practice in 2012, returning to Texas from orthopedic practice in California in 1992. He attended medical school at the University of Texas Health Science Center at San Antonio and received his orthopedic surgery residency training at Loma Linda University Hospital, Rancho los Amigos Hospital, and affiliated hospitals in southern California. Dr. Davis is a fellow of the American Academy of Orthopaedic Surgeons.
Edwin R. Buster III, M.D. 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: 10/21/2014