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Texas Department of Insurance
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Performance Based Oversight (PBO) System Results

Section 402.075 of the Texas Labor Code mandates DWC to, at least biennially, assess the performance of insurance carriers and health care providers. Based on the performance assessment, insurance carriers and health care providers will be placed into regulatory tiers: poor performers, average performers, and consistently high performers. DWC must then focus its regulatory oversight on the poor performers. Insurance carriers will be assessed in even numbered years and health care providers will be assessed in odd numbered years.

Helpful Links: PBO-Home Page | PBO-Learn More | IC PBO Info | HCP PBO Info

Overall System Results | 2020 Insurance Carrier Results | 2021 Health Care Provider Results

PBO Overall Assessments System Results

Link to current insurance carrier methodology paper and health care provider assessment methodology paper

2020 Insurance Carrier Tier Assessments System Results

  Number of Insurance Carriers High Tier Performers Average Tier Performers Poor Tier Performers
All insurance carriers were assessed on the same measures 120 40 76 4

2021 Health Care Provider Tier Assessments System Results

  Number of Providers High Tier Performers Average Tier Performers Poor Tier Performers
DWC Form-069, Report of Medical Evaluation Category 96 66 15 15
DWC Form-073, Work Status Report Category 91 45 38 8

2020 Insurance Carrier Assessment Details

System Results

Number of Insurance Carriers High Tier Performers Average Tier Performers Poor Tier Performers
All insurance carriers were assessed on the same measures 120 40 76 4

System Results PER Measure

Measures Measure Weights High Tier Performers Average Tier Performers Poor Tier Performers
Timely payment of initial Temporary Income Benefits 50% weight 25 72 23
Timely submission of Initial Payment data via EDI 5% weight 60 46 14
Timely processing of initial medical bills 30% weight 115 5 0
Timely processing of request for reconsideration medical bills 10% weight 70 43 7
Timely submission of medical bill processing data via EDI 5% weight 109 9 2

Insurance Carrier Tier Placements

High Tier Performers Average Tier Performers Poor Tier Performers
Ascension Health Alliance
BITCO General Insurance Corp
City of Amarillo
City of Austin
City of Dallas
City of El Paso
City of Houston
City of San Antonio
Deep East Texas Self Insurance Fund
East Tx Educational Ins Assn
El Paso ISD
Federated Mutual Insurance Co
Federated Reserve Insurance Co
Fedex Freight Inc
Fort Worth ISD
Great American Alliance Insurance Co
Harris County
Houston ISD
Incline Casualty Co
Insurance Company of the West
Lockheed Martin Corp
Metropolitan Transit Authority Harris Co
North East Independent School District
Old Glory Insurance Co
Property & Casualty Ins Co of Hartford
Richardson ISD
Sentinel Insurance Company Ltd
Service Lloyds Insurance Co
State Office of Risk Management
TASB Risk Mgmt Fund
Texas Municipal League Intergovernmental Risk Pool
Texas Mutual Insurance Co
Tx Assoc of Counties RMP
Tx Public School WC Project
UMC Health System
Valley Forge Insurance Co
WC Solutions
Ysleta ISD
Zenith Insurance Co
Znat Insurance Co
Accident Fund General Insurance Co
Accident Fund Insurance Co of America
Accident Fund National Insurance Co
Ace American Insurance Co
American Casualty Co of Reading PA
American Zurich Insurance Co
Amerisure Insurance Co
Amerisure Mutual Insurance Co
Amtrust Ins Co of Kansas Inc
Arch Indemnity Insurance Co
Arch Insurance Co
Berkley National Insurance Co
Berkshire Hathaway Homestate Insurance Co
Bridgefield Casualty Insurance Co
Charter Oak Fire Insurance Co
Church Mutual Insurance Co
City of Fort Worth
Dallas Area Rapid Transit
Employers Insurance Co of Wausau
Employers Preferred Ins Co
Farmington Casualty Co
Federal Insurance Co
Federated Service Insurance Co
Fedex Ground Package System Inc
First Liberty Insurance Corp
Great West Casualty Co
Hartford Casualty Insurance Co
Hartford Fire Insurance Co
Hartford Underwriters Insurance Co
Indemnity Insurance Co of North America
Insurance Co of the State of PA
Lamar CISD
Liberty Insurance Corp
Liberty Mutual Fire Insurance Co
LM Insurance Corp
Markel Insurance Co
Mitsui Sumitomo Insurance Co of America
Monroe Guaranty Insurance Company
National Union Fire Ins Co of Pittsburgh PA
New Hampshire Insurance Co
Norguard Insurance Co
Ohio Security Insurance Co
Old Republic Insurance Co
Phoenix Insurance Co
Plano Independent School District
Protective Insurance Co
QBE Insurance Corporation
Redwood Fire & Casualty Ins Co RFCIC
Retailers Casualty Insurance Co
Safety National Casualty Corp
Sentry Casualty Co
Sentry Insurance A Mutual Co
Sompo America Insurance Co
Standard Fire Insurance Co
Starbucks Corp
Starr Indemnity & Liability Co
Starr Specialty Insurance Co
Tarrant County
Technology Insurance Co
Texas Council Risk Management Fund
TPS Joint Self Ins Funds
Travelers Casualty & Surety Co
Travelers Casualty Ins Co of America
Travelers Indemnity Co
Travelers Indemnity Co of America
Travelers Indemnity Co of Connecticut
Travelers Property Casualty Company of America
Trumbull Insurance Co
United Airlines Inc
United Wisconsin Insurance Co
Vanliner Insurance Co
Wesco Insurance Co
XL Insurance America Inc
XL Specialty Insurance Co
Zurich American Ins Co of Illinois
Zurich American Insurance Co
ACIG Insurance Co
Dallas County Hospital District
Everest National Insurance Co
Everest Premier Insurance Co

2021 Health Care Provider Assessment Details per Measure Categories

CATEGORY - DWC Form-069, Report of Medical Evaluation

System Results

Measure Number of Providers High Tier Performers Average Tier Performers Poor Tier Performers
Timeliness of filing the DWC Form-069, Report of Medical Evaluation 96 66 15 15

Tier Placements - DWC Form-069, Report of Medical Evaluation Category

High Tier Performers Average Tier Performers Poor Tier Performers
Raymond Talmadge Alexander, MD
Suhail S. Al-Sahli, DC
David Alvarado, DC
Steven Reed Anderson, DC
Emily Bailey, DC
James Bales, MD
David Clark Baugher, DC
Kirk Bradford, DC
Robert Elliott Canal, DC
Kelly D. Clenney, DC
Joseph Scott Coleman, DC
Viraf Rustom Cooper, MD
Jeff Cunningham, DC
Brent Allen Curtis, DC
John Franklin Davis, DC
Ronald Dejong, DC
Brent Dale Dreier, DC
Donald Gene Eaves, DC
Ayodele Fadahunsi, DC
Gene Jay Fields, Jr., DC
Aaron E. Ford, DC
Andrew Ray Garcia, Jr., DC
Andrew Goodman, DC
Linda Gregory, DO
David Martin Griffith, DC
Kyle Burk Hammes, DC
Marcus Paul Hayes, DC
Charles Wayne Hebert, DC
Crystal Hogan, DC
Joe Hugghins, DC
Steven Dean Huneycutt, DC
Robert Jaehne, DC
Stephanie Janiak, DC
Scott Jurica, DC
Darla Kay Kelly, DC
John Dale Kirkwood, DO
Milton E. Kirkwood, DO
Judith-Ann M. Knowles, DC
Danny J. Kurth, DC
Kevin Troy Landry, DC
Richard Burnett Lawrence, III, MD
Aaron Martin Levine, MD
Leonard P. Lopez, DC
Jack Paul Mitchell, Jr., DC
Samuel Zarate Moya, DC
Martin A. Munoz, DC
James Christian Pitts, DC
Juan Francisco Quiroz, MD
Rafath Quraishi, MD
Nilima Rai, MD
Jared C. Rosenberg, DC
Hooman Sedighi, MD
Gregory Bruce Sheppard, DC
John Anthony Sklar, MD
Edward William Smith, DO
Kenneth Steen, DC
Donnel Rex Steuerwald, DC
Steven Glenn Sykes, DC
Neil A. Szeryk, DC
Mary Terrell, MD
Duane F. Vincent, DC
Almaya Wadley, DC
Jason Aubrey Watkins, DC
Joe W. Wiggins, DC
Evan Willian, DC
Charles Fred Xeller, MD
Charles Anthony Collins, DC
Angela B. Cox, DC
Chris Blake Davis, DC
Sheri Ekukpe, DC
Keven Mirk Ellis, DC
Terence Oneal Floyd, DC
Clint Hardin, DC
James Furniss Hood, MD
Pedro Julio Lozano, DC
Kevin Lee Prentice, DC
Robbie Rampy, MD
Charles Silver, MD
Corey Walter Skinner, DC
Tyanna Sutton, DC 
Terry Jackman Beal, MD
Suki Chapa, DC
Lida S. Dahm, MD
Jason Levon Eaves, DC
Parvaneh Ehsanzadeh, MD
Ahmed A. H. Khalifa, MD
Michael Martin Leonard, MD
Keith Ward Louden, MD
Joyce Lyon, MD
Benjamin Maurice Meshack, DC
Anthony Owusu, Jr., MD
Jan Riefer Petrasek, MD
Valorie Robertson, MD
Courtney Walls, DC
Gary Richard Williams, MD

 

Category - DWC Form-073, Work Status Report

System Results

Category Number of Providers High Tier Performers Average Tier Performers Poor Tier Performers
DWC Form-073, Work Status Report 91 45 38 8
Measures Measure Weights Number of Providers High Tier Performers Average Tier Performers Poor Tier Performers
Completeness of the DWC Form-073, Work Status Report 30% weight 91 47 32 12
Documentation supporting how the injured employee’s medical condition prevents them from returning to (any) work as reported on the DWC Form-073, Work Status Report 70% weight 91 53 30 8

Tier Placements - DWC Form-073, Work Status Report Category

High Tier Performers Average Tier Performers Poor Tier Performers
Sukanya Ambavaram, MD
Noli Cantuba Cantuba Baldeo, MD
Rosa Anna Belena-Bruce, MD
Scott Barry Bischoff, MD
Shamarick Gaston Blue, MD
Charles William Breckenridge, MD
Sonya Laneete Brock, MD
Neelima Chirumamilla, MD
Danielle Kay Coulter, MD
Anh Tu Dang, MD
John D. Dang, MD
Brandon Scott Elrod, DO
Savithri Hapuhennadige Fernando, MD
Barnabas Talla Fote, MD
Gerard Thomas Gabel, MD
Majdouleen Michil Georgeos, MD
David Patricio Gonzalez Gibler, MD
Linda Gregory, DO
Richard Frederick Haenke, DO
Mark Howard Henry, MD
Omer A. Ilahi, MD
Michael G. Iversen, MD
Anly Joseph, MD
Michael Gregory Kaldis, MD
Kevin Lee Kirk, DO
Frank Charles Kretsinger, DO
Lonniejay Latimer, MD
Derek K. Lichota, MD
Shauna Lyn, MD
Dixie P. McCrory, MD
Shannon Marie Mitchel, MD
Edgardo Lozano Montemayor, Jr., MD
Gregory Lane Naugher, MD
Bryan J. Novosad, MD
Clayton Nuelle, MD
Scott Thomas Orth, MD
James Robert Parker, MD
Daniel H. Pham, MD
Steven Clayton Riley, MD
James Keith Rose, MD
Penni Melissa Russo-Going, MD
Rodney Kent Van Andel, MD
Jose Victor Vela, MD
Kathryn Annette Winick, MD
Mi Mickey Yang, MD
Kimberly Ann Abernethy, DO
Michael Miles Albrecht, Jr., MD
Robert Stanley Antonetti, MD
Silvio Azzolini, MD
Shiu-Yueh Baxter, MD
Eric Frank Berkman, MD
Judith Martin Cadore, MD
John Choe, MD
Jean Theresa Dolan, MD
Michael Henry Grandison, DO
Warren G. Hatley, Jr., MD
David Ayrton Holland, MD
Walter Grear Hurt, MD
Gene Joe, DO
Myron D. Jones, Jr., DO
Terren David Klein, MD
Louise Lamarre, MD
Larry Bernard Lipscomb, MD
Mathew Lynn Loewen, DO
Terence Phillip Macconnell, MD
Alton Marcello, MD
Douglas James Mills, MD
Christine Elaine Morgan, MD
Son Kim Nguyen, MD
Olubunmi Temitope Ogunleye, MD
Enrique Porras, MD
Nilima Rai, MD
Theresa Rameden, MD
Marshall Brooks Robert, MD
Steven William Schierman, MD
Ramesh Srinivasan, MD
Eugene Frank Stautberg, III, MD
John Summerfield Townsend, IV, MD
Jose Guillermo Trevino, MD
George Samuel Walls, III, MD
Andrew Lawrence Whaley, MD
David Juan Zehr, MD
Nikola Zivaljevic, MD
David Bloome, MD
Juan Carlos Bustos, MD
Andrew Paul Freese, MD
Dominic Linus Gross, MD
Kerry Duane Inzer, DO
Guillermo Ruben Pechero, MD
Joseph R. Rosiles, MD
Steven J. Thornton, MD

 

For more information, contact: PBO@tdi.texas.gov

Last updated: 2/16/2022