Workers' compensation disciplinary orders after 2019
Disciplinary orders before 2019: 2012 | 2013 | 2014 | 2015 | 2016 | 2017 | 2018
| Order number | Date issued | Subject | Action taken | Violation |
|---|---|---|---|---|
| 3752 | 12/23/2014 | City of Houston | Fined $8,000 | Failed to comply with benefit dispute agreement |
| 3751 | 12/23/2014 | Starr Indemnity & Liability Company | Fined $5,500 | Failed to timely pay income benefits to injured employee; Failed to accurately notify TDI-DWC and injured employee of actions taken on a claim |
| 3749 | 12/22/2014 | Property and Casualty Insurance Company of Hartford | Fined $8,000 | Failed to timely pay benefits in accordance with designated doctor's opinion |
| 3743 | 12/19/2014 | Ace American Insurance Company | Fined $1,000 | Failed to provide list of all injured worker injuries determined to be compensable by TDI-DWC or as accepted as compensable by insurance carrier |
| 3742 | 12/19/2014 | Everest National Insurance Company | Fined $25,000 | Failed to timely act on a properly completed medical bill; Failed to timely submit accurate medical EDI records to TDI-DWC |
| 3741 | 12/19/2014 | Genesis Insurance Company | Fined $35,000 | Failed to timely act on a properly completed medical bill; Failed to submit accurate medical EDI bills to TDI-DWC |
| 3740 | 12/19/2014 | Great Midwest Insurance Company | Fined $3,400 | Failed to timely pay income benefits to injured employee; Failed to accurately notify TDI-DWC and injured employee of actions taken on a claim |
| 3739 | 12/19/2014 | Kinnison, David Wayne D.C. | Fined $1,000; Cannot apply or reapply for certification as a designated doctor until after March 31, 2017 | Failed to timely respond to request for clarification |
| 3744 | 12/19/2014 | SeaBright Insurance Company | Fined $16,000 | Failed to timely act on a properly completed medical bill; Failed to timely submit accurate medical EDI records to TDI-DWC |
| 3745 | 12/19/2014 | Sentry Casualty Company | Fined $4,400 | Failed to timely pay temporary income benefits to injured employee; Failed to accurately report benefits and payment data to TDI-DWC |
| 3746 | 12/19/2014 | Texas Mutual Insurance Company | Fined $12,000 | Failed to timely comply with a commissioner's order to produce information; Failed to notify the division of refusal to pay a medical bill; Failed to timely pay impairment benefits based on a designated doctor's opinion |
| 3748 | 12/19/2014 | Valley Forge Insurance Company | Fined $6,000 | Failed to timely pay temporary income benefits to injured employee; Failed to accurately report initial temporary income data to TDI-DWC |
| 3729 | 12/18/2014 | Eaves, Jason L., D.C. | Fined $1,000 | Failed to timely file and/or accurately complete TDI-DWC forms, reports or records |
| 3730 | 12/18/2014 | El Paso Orthopedic Surgery Center | Fined $2,000 | Improperly billed an injured employee for workers' compensation medical services provided |
| 3731 | 12/18/2014 | Medical Center of Arlington | Fined $4,000 | Improperly pursued a private claim against an employer; Failed to comply with an Order to Produce |
| 3732 | 12/18/2014 | Phoenix Insurance Company | Fined $5,750 | Failed to timely pay temporary income benefits to injured employee; Failed to accurately report income benefits data to TDI-DWC |
| 3733 | 12/18/2014 | Technology Insurance Company | Fined $9,000 | Failed to timely pay temporary income benefits to injured employee; Failed to timely notify TDI-DWC and injured employee of actions taken on a claim |
| 3714 | 12/11/2014 | Chubb Indemnity Insurance Company | Fined $9,000 | Failed to timely pay benefits based on the opinion of designated doctor during pendency of a dispute |
| 3713 | 12/11/2014 | Federal Insurance Company | Fined $4,000 | Failed to timely pay income benefits to injured employee |
| 3712 | 12/11/2014 | Zurich American Insurance Company | Fined $3,400 | Failed to timely issue payment to health care provider |
| 3696 | 12/2/2014 | Arch Insurance Company | Fined $700 | Failed to timely comply with an order for advance payment of income benefits to injured employee |
| 3695 | 12/2/2014 | Dallas Medical Center | Fined $15,000 | Failed to respond to a request for a refund from insurance carrier |
| 3697 | 12/2/2014 | Liberty Insurance Corporation | Fined $9,000 | Failed to pay benefits in accordance with designated doctor's opinion; Failed to timely comply with TDI-DWC decision and order |
| 3698 | 12/2/2014 | New Hampshire Insurance Company | Fined $89,000 | Failed to timely submit accurate medical bill and payment EDI records to TDI-DWC; Failed to timely pay income benefits to injured employee; Failed to take action on a properly completed medical bill; Failed to timely process a travel reimbursement request; Failed to timely process a completed medical bill; Failed to timely submit accurate medical EDI records to TDI-DWC; Failed to timely provide information requested by an injured employee; Failed to timely pay attorney's fees; Failed to provide list of all injured worker injuries determined to be compensable by TDI-DWC or as accepted as compensable by insurance carrier; Failed to timely pay in accordance with a Benefit Dispute Agreement; Failed to report to TDI-DWC the initial payment of income benefits |
| 3694 | 12/2/2014 | Prentice, Kevin Lee D.C. | Fined $2,000 | Failed to timely file and/or accurately complete TDI-DWC forms, reports or records |
| 3699 | 12/2/2014 | Protective Insurance Company | Fined $9,000 | Failed to timely pay temporary income benefits to injured employee; Failed to timely notify TDI-DWC and injured employee of actions taken on a claim |
| 3700 | 12/2/2014 | Texas Public School Workers' Compensation Project | Fined $7,500 | Failed to timely pay income benefits to injured employee; Failed to timely notify TDI-DWC and injured employee of actions taken on a claim |
| 3701 | 12/2/2014 | Twin City Fire Insurance Company | Fined $3,000 | Failed to comply with TDI-DWC order |
| 3690 | 12/1/2014 | Quiroz, Juan Francisco M.D. | Fined $750 | Failed to timely file and/or accurately complete TDI-DWC forms, reports or records |
| 3683 | 11/19/2014 | Beman, Douglas L., D.C. | Fined $1,000; Must complete medical training | Failed to provide acceptable health care to injured employee including: Improperly utilized diagnostic tests not supported by medical record or evidence-based criteria |
| 3684 | 11/19/2014 | The Netherlands Insurance Company | Fined $6,000 | Failed to timely pay benefits to injured employee; Failed to submit accurate payment data to TDI-DWC |
| 3671 | 11/18/2014 | Accident Fund General Insurance Company | Fined $28,000 | Failed to timely act on a properly completed medical bill; Failed to submit accurate medical EDI records to TDI-DWC |
| 3672 | 11/18/2014 | American Home Assurance Company | Fined $2,000 | Failed to timely act on a properly completed medical bill |
| 3673 | 11/18/2014 | Arch Insurance Company | Fined $10,000 | Failed to timely act on a properly completed medical bill; Failed to timely submit accurate medical EDI records to TDI-DWC |
| 3670 | 11/18/2014 | Halaby, Gerald A., M.D. | Must complete medical training including required designated doctor certification | Failed to provide acceptable care to injured employee including meeting minimum requirements of designated doctors |
| 3669 | 11/18/2014 | Mayorga, Gilbert, Jr., M.D. | Fined $5,000; Must complete assigned CME courses within 180 days | Failed to adequately assess and monitor injured employees in four cases when prescribing opioids; Failed to establish return-to-work goals |
| 3674 | 11/18/2014 | Pacific Indemnity Company | Fined $3,000 | Failed to timely act on a properly completed medical bills; Failed to submit accurate medical EDI records to TDI-DWC |
| 3675 | 11/18/2014 | Sparta Insurance Company | Fined $15,000 | Failed to timely act on a properly completed medical bill; Failed to submit accurate medical EDI records to TDI-DWC |
| 3676 | 11/18/2014 | Work First Casualty Company | Fined $6,000 | Failed to timely act on a properly completed medical bill; Failed to submit accurate medical EDI records to TDI-DWC |
| 3598 | 10/22/2014 | Ace American Insurance Company | Fined $45,000 | Failed to accurately and timely pay benefits to an injured employee; Failed to accurately pay death benefits; Failed to notify TDI-DWC and injured employee of actions taken on a claim |
| 3591 | 10/22/2014 | Caldwell, Rodney Lynn M.D. | Fined $3,600 | Failed to timely file and/or accurately complete TDI-DWC forms, reports or records |
| 3594 | 10/22/2014 | Cherokee Insurance Company | Fined $10,000; Must submit required medical EDI data | Failed to timely submit medical bill and payment data via EDI to TDI-DWC |
| 3595 | 10/22/2014 | Corpus Christi I.S.D. | Fined $3,000 | Failed to timely issue payment of supplemental income benefits to an injured employee in a subsequent quarter |
| 3596 | 10/22/2014 | Liberty Mutual Fire Insurance Company | Fined $2,500 | Failed to comply with TDI-DWC order to provide information for a designated doctor examination |
| 3592 | 10/22/2014 | Marshall, George Kenneth M.D. | Must not accept new patients in nor participate in Texas workers' compensation system as a health care provider; Must refer existing patients to other providers | Administered improper, unreasonable, or medically unnecessary treatment by treating an injured employee for a diagnosis not supported by the medical record |
| 3593 | 10/22/2014 | Newton, Lesley M.D. | Agrees not to re-apply for designated doctor list nor to apply to certify maximum medical improvement and assign impairment ratings for two years | Failed to timely file proper forms and narrative reports following five designated doctor examinations |
| 3597 | 10/22/2014 | The Insurance Company of the State of Pennsylvania | Fined $6,500 | Failed to timely submit medical bill and payment data via EDI to TDI-DWC; Failed to timely act on an injured employee's request for travel reimbursement |
| 3573 | 10/9/2014 | OneBeacon America Insurance Company | Fined $5,500 | Submitted inaccurate medical EDI records to TDI-DWC |
| 3574 | 10/9/2014 | Pacific Employers Insurance Company | Fined $3,000 | Improperly denied reimbursement based on medical necessity for preauthorized health care |
| 3575 | 10/9/2014 | Tarrant County College District | Fined $9,000 | Failed to timely act on a properly completed medical bill; Failed to submit accurate medical EDI records to TDI-DWC |
| 3572 | 10/9/2014 | Weeks, Trenton David D.C. | Fined $1,000; Must complete medical record documentation training | Evaluation of injured employee's work status, ability to work, work restrictions and medical condition deficient and lacked testing description or data to support conclusions |
| 3557 | 9/23/2014 | Burgesser, Mary Francis M.D. | Permanently removed from Texas workers' compensation system as a health care provider | Provided treatments and/or evaluations substantially different from those found by commissioner to be fair and reasonable which were based on inadequate medical record documentation |
| 3548 | 9/18/2014 | American Zurich Insurance Company | Fined $15,500 | Failed to timely and accurately notify TDI-DWC and injured employee of actions taken on a claim; Failed to timely pay benefits based on opinion of designated doctor during pendency of dispute; Failed to timely act on a properly completed medical bill; ; failed to properly submit request for designated doctor examination |
| 3547 | 9/18/2014 | Zurich American Insurance Company | Fined $5,500 | Failed to use TDI-DWC's adopted medical fee guidelines for reimbursement of professional medical service |
| 3534 | 9/16/2014 | Hartford Insurance Company of the Midwest | Fined $40,000 | Failed to pay income benefits in accordance with designated doctors report; Violated and/or failed or refused to comply with commissioner rule or a provision of Texas Workers' Compensation Act |
| 3533 | 9/16/2014 | The Travelers Indemnity Company | Fined $11,500 | Failed to issue timely payment to health care provider; Failed to timely act on request for reconsideration |
| 3531 | 9/15/2014 | Safety National Casualty Corporation | Fined $1,000 | Failed to timely comply with a decision of the commissioner |
| 3523 | 9/9/2014 | Holland, Christine Westmoreland M.D. | Fined $2,000 | Improperly billed an injured employee for workers' compensation medical services provided |
| 3521 | 9/9/2014 | Marshall, C. Perry M.D, | Fined $7,500 | Failed to timely file and/or accurately complete TDI-DWC forms, reports or records |
| 3524 | 9/9/2014 | National Interstate Insurance Company | Fined $5,000 | Failed to timely pay income benefits to injured employee based on opinion of designated doctor during pendency of dispute |
| 3477 | 9/9/2014 | Siebenaler, Frank J., Jr., D.C. | Fined $1,000 | Submitted information to TDI-DWC that misrepresented an accurate and/or consistent certification date for results of designated doctor examination |
| 3525 | 9/9/2014 | The Standard Fire Insurance Company | Fined $1,500 | Failed to properly submit request for designated doctor examination |
| 3526 | 9/9/2014 | XL Specialty Insurance Company | Fined $8,500 | Failed to timely pay income benefits to injured employee; Failed to accurately notify TDI-DWC and injured employee of actions taken on a claim; Failed to timely report initial payment of indemnity benefits to TDI-DWC; Failed to timely act on a properly completed medical bill. |
| 3509 | 8/27/2014 | Great American Alliance Insurance Company | Nunc Pro Tunc DWC # 3389 | Not applicable |
| 3510 | 8/27/2014 | Hartford Underwriters Insurance Company | Fined $14,000 | Failed to timely pay income benefits to injured employees |
| 3491 | 8/20/2014 | Behrens Southern Comfort Medical Supply | Fined $1,000 | Improperly billed an injured employee for workers' compensation services provided |
| 3492 | 8/20/2014 | Christus Jasper Memorial | Fined $2,000 | Improperly billed an injured employee for workers' compensation services provided |
| 3494 | 8/20/2014 | Companion Property and Casualty Insurance Company | Fined $28,500 | Failed to timely act on a properly completed medical bill; Failed to submit accurate EDI records to TDI_DWC |
| 3494 | 8/20/2014 | Companion Property and Casualty Insurance Company | Fined $28,500 | Failed to timely process medical bills |
| 3490 | 8/20/2014 | Shade, Ronnie D., M.D. | Fined $1,000; Must completed medical records training | Failed to use return-to-work guidelines to establish goals and plan with injured employee; Failed to explain in work status report how employee's injury prevented return to work |
| 3493 | 8/20/2014 | Texas Health Presbyterian Hospital of Plano | Fined $4,000 | Improperly billed and injured employee for workers' compensation services provided |
| 3477 | 8/8/2014 | Arch Insurance Company | Fined $4,700 | Failed to timely act on a properly completed medical bill; Failed to timely respond to request from an injured employee; Failed to timely act on request for reconsideration |
| 3467 | 7/31/2014 | American Guarantee and Liability Insurance Company | Fined $11,000 | Failed to timely act on a properly completed medical bill; Failed to submit accurate medical EDI records to TDI-DWC |
| 3469 | 7/31/2014 | Earle, Stephen Edward M.D. | Removed from Texas workers' compensation system as a health practitioner for five years; Shall not receive direct or indirect remuneration from the Texas workers' compensation system for services performed after date of order | Failed to document appropriate justification for intraoperative examinations and procedures performed on injured employees; Failed to document instability and/or need for procedures performed on injured employees |
| 3462 | 7/30/2014 | Creative Risk Funding, Inc. | Fined $20,000; Cease and desist from performing utilization review without certificate of registration | Utilization review not conducted by licensed physician; Adjuster performing retrospective review of medical doctor visits not properly licensed; Issued medical necessity denials without allowing health care provider reasonable opportunity to discuss with medical doctor |
| 3466 | 7/30/2014 | Starr Comprehensive Solutions, Inc. | Fined $25,000 | Personnel performing retrospective reviews not properly licensed; Issued medical necessity denials without allowing health care provider reasonable opportunity to discuss with medical doctor |
| 3440 | 7/28/2014 | Argonaut Insurance Company | Fined $24,000 | Failed to timely pay income benefits to injured employees as ordered by TDI-DWC |
| 3439 | 7/28/2014 | Ascension Health | Fined $5,000 | Failed to timely pay income benefits to injured employee |
| 3441 | 7/28/2014 | Bradford Holding Company, Inc. | Fined $17,000 | Failed to timely act on a properly completed medical bill; Failed to submit accurate medical EDI records to TDI-DWC |
| 3434 | 7/25/2014 | The Netherlands Insurance Company | Fined $24,000 | Failed to timely and accurately pay income benefits to injured employee; Failed to accurately pay death benefits; Failed to notify TDI-DWC of action taken on claims |
| 3431 | 7/22/2014 | Neurosurgical Specialists of El Paso, P.L.L. | Fined $3,500 | Improperly billed an injured employee for workers' compensation medical services provided |
| 3432 | 7/22/2014 | Old Republic Insurance Company | Fined $12,500 | Failed to pay accurate benefits to injured employee; Failed to notify injured employee and TDI-DWC of actions on a claim; Failed to timely pay attorneys fees |
| 3420 | 7/21/2014 | Ace American Insurance Company | Fined $4,000 | Failed to timely act on a properly completed medical bill; Failed to submit request for designated doctor examination in proper form |
| 3423 | 7/21/2014 | General Casualty Company of Wisconsin | Fined $12,000 | Failed to submit accurate medical EDI records to TDI-DWC |
| 3429 | 7/21/2014 | Hartford Casualty Insurance Company | Fined $1,000 | Failed to timely pay attorneys fees |
| 3424 | 7/21/2014 | Indemnity Insurance Company of North America | Fined $4,000 | Failed to timely act on a properly completed medical bill; Failed to properly submit request for designated doctor examination |
| 3525 | 7/21/2014 | Injury Rehab Clinic | Fined $2,000 | Failed to timely respond to request for a refund from an insurance carrier; Failed to timely comply with a TDI-DWC order |
| 3428 | 7/21/2014 | QBE Insurance Corporation | Fined $47,000 | Failed to timely act on a properly completed medical bill; Failed to submit accurate medical EDI records to TDI-DWC |
| 3426 | 7/21/2014 | The CompPAC Trust of Texas | Fined $18,500 | Failed to submit accurate medical EDI records to TDI-DWC |
| 3427 | 7/21/2014 | The Mercantile Trust of Texas | Fined $16,000 | Failed to timely act on a properly completed medical bill; Failed to submit accurate medical EDI records to TDI-DWC |
| 3422 | 7/21/2014 | Travelers Casualty Insurance Company of America | Fined $10,000 | Failed to comply with requirements for income benefits payments and reporting |
| 3421 | 7/21/2014 | Wolinsky, Joel Scott M.D. | Fined $500 | Adopted and interpreted a medical test that had been improperly conducted |
| 3419 | 7/18/2014 | Allen I.S.D. | Fined $12,000 | Failed to submit accurate medical EDI records to TDI-DWC |
| 3418 | 7/18/2014 | Southern Vanguard Insurance Company | Fined $13,500 | Failed to submit accurate medical billing and payment data to TDI-DWC |
| 3417 | 7/18/2014 | Warren, G. Emory, M.D. | Fined $1,000 | Failed to timely provide medical records on an injured employee after receiving an order to produce them |
| 3403 | 7/10/2014 | Accident Fund Insurance Company of America | Fined $19,000 | Failed to timely pay income benefits to injured employee; Failed to notify TDI-DWC and injured employee of actions taken on a claim |
| 3402 | 7/10/2014 | Ace American Insurance Company | Fined $44,079 | Failed to submit accurate medical billing and payment data; Failed to timely act on a properly completed medical bill; Failed to timely file and/or accurately complete TDI-DWC forms, reports or records |
| 3404 | 7/10/2014 | Berkshire Hathaway Homestate Insurance Company | Fined $32,000 | Failed to timely act on properly completed medical bill; Failed to accurately submit medical EDI records to TDI-DWC; Failed to timely pay income benefits to injured employee |
| 3405 | 7/10/2014 | El Paso I.S.D. | Fined $6,600 | Failed to timely notify TDI-DWC of initial payment of income benefits to injured employee; Failed to accurately submit medical billing and payment data to TDI-DWC |
| 3400 | 7/10/2014 | Sanchez, Mario Alonzo D.O. | Fined $1,000; Must complete medical training approved by TDI-DWC | Failed to practice medicine or provide health care in an acceptable manner consistent with public health, safety and welfare |
| 3401 | 7/10/2014 | Sierra Medical Center | Fined $1,000 | Improperly billed an injured employee for workers' compensation medical services provided |
| 3395 | 7/7/2014 | American Home Assurance Company | Fined $7,848 | Failed to submit accurate medical billing and payment data; Failed to timely and accurately notify TDI-DWC of action taken on a claim |
| 3392 | 7/7/2014 | California Insurance Company | Fined $32,000 | Failed to timely provide services requested by policyholders; Failed to timely act on a properly completed medical bill; Failed to timely submit a accurate medical billing EDI records |
| 3389 | 7/7/2014 | Great American Alliance Insurance Company | Fined $7,500 | Failed to comply with requirements for initial payment of income benefits to injured employees |
| 3387 | 7/7/2014 | Morris, Jerry W., D.O. | Voluntarily surrendered and must never re-apply for designated doctor certification in Texas workers' compensation system | Failed to timely respond to TDI-DWC request for letter of clarification; Failed to timely file and/or accurately complete TDI-DWC forms, reports or records |
| 3386 | 7/7/2014 | Perez, Abimael M.D. | Removed from Texas workers' compensation system as a health care provider | Failed to document how treatment provided functional improvement to enhance ability of injured employee to return to work or retain employment; Failed to maintain efficient utilization of health care services to provide meaningful treatment to improve function |
| 3390 | 7/7/2014 | Remirez, Carlos Manuel M.D. | Fined $3,000; Must complete medical training approved by TDI-DWC | Failed to timely provide health care services by failing to incorporate active physical therapy in addition to medication for injured employee |
| 3385 | 7/7/2014 | West, David Adam D.O. | Fined $500; Must provide certification of training completed | Failed to timely notify TDI-DWC of disqualifying association after being selected as designated doctor of examination of injured employee |
| 3370 | 6/27/2014 | Caldwell, Rodney Lynn M.D. | Fined $3,000 | Failed to timely file and/or accurately complete TDI-DWC forms, reports or records; Failed to timely respond to a request for clarification from TDI-DWC |
| 3371 | 6/27/2014 | Chin, Arthur Kelvin M.D. | Removed from workers' compensation system as health care provider | Failed to appropriately document medical evaluations; Failed to document use of the MDA Guides to establish return-to-work goals |
| 3365 | 6/20/2014 | Chavda, Deepak M.D. | Removed from designated doctor list for five years; Must not certify MMI or IR as part of a referral from another health care practitioner | Failed to provide sufficient documentation to justify maximum medical improvement (MMI) date and impairment rating (IR), and provided unnecessary tests as part of designated doctor examinations |
| 3357 | 6/20/2014 | Samlowski, Eberhard R., M.D. | Permanently denied designated doctor certification | Failed to timely file and/or accurately complete TDI-DWC forms, reports or records; Failed to comply with commissioner rule or provision of Act |
| 3344 | 6/17/2014 | Boudreau, Daniel Alexander D.O. | Fined $1,500 | Failed to maintain accurate records including injured employee's medical records for a designated doctor examination |
| 3342 | 6/17/2014 | Houston I.S.D. | Fined $4,968 | Failed to notify TDI-DWC and injured employee of actions taken on a claim; Failed to timely report initial payment of indemnity benefits; Failed to accurately submit medical EDI records to TDI-DWC |
| 3343 | 6/17/2014 | National Union Fire Insurance Company of Pittsburgh, PA | Fined $4,491 | Failed to accurately submit medical bill and payment data |
| 3323 | 6/2/2014 | Tobola Electric | Fined $1,000 | Failed to comply with Commissioner's Order to provide requested information about workers' compensation coverage status |
| 3316 | 5/30/2014 | East Texas Medical Center | Fined $4,000 | Failed to respond to request for a refund from insurance carrier |
| 3318 | 5/30/2014 | Illinois National Insurance Company | Fined $12,774 | Failed to submit accurate medical billing and payment data |
| 3321 | 5/30/2014 | Lumbermen's Underwriting Alliance | Fined $4,779 | Failed to accurately submit medical bill and payment data |
| 3319 | 5/30/2014 | New Hampshire Insurance Company | Fined $29,981 | Failed to accurately submit medical bill and payment data; Failed to timely notify TDI-DWC and injured employee of actions taken on a claim |
| 3317 | 5/30/2014 | Texas Political Subdivisions Joint Self Insurance Funds | Fined $11,000 | Failed to timely pay benefits to injured employee; Failed to notify TDI-DWC and injured employee of actions taken on a claim |
| 3320 | 5/30/2014 | The Insurance Company of the State of Pennsylvania | Fined $8,397 | Failed to accurately submit medical bill and payment data |
| 3308 | 5/20/2014 | Castlepoint National Insurance Company | Fined $16,029 | Failed to notify TDI-DWC and injured employee of actions taken on a claim; Failed to timely pay benefits to injured employee; Failed to accurately submit medical bill and payment data |
| 3306 | 5/20/2014 | Federal Insurance Company | Fined $3,000 | Failed to timely remit payment to independent review organization |
| 3307 | 5/20/2014 | Indemnity Insurance Company of North America | Fined $30,599 | Failed to accurately submit medical bill and payment data; Failed to timely respond to request for reconsideration; Failed to timely pay benefits to injured employee |
| 3305 | 5/20/2014 | Wali, Gouher M.D. | Must complete medical record documentation training; Must complete online medical education course | Failed to document sufficient medical evidence and/or medical rationale to justify treatment of injured employees; Failed to document reasons for ordering work restrictions or for not establishing return to work plans for injured employees |
| 3292 | 5/15/2014 | Arch Insurance Company | Fined $40,143 | Failed to timely pay benefits to injured employee; Failed to notify TDI-DWC and injured employee of actions taken on a claim; Failed to accurately submit medical bill and payment data; Failed to timely pay accrued benefits according to designated doctor's report |
| 3295 | 5/15/2014 | Donna I.S.D. | Fined $4,000 | Breached provision of benefits dispute agreement requiring timely compliance |
| 3293 | 5/15/2014 | Duclair, Cesar Pierre M.D. | Fined $2,000 | Failed to timely file and/or accurately complete TDI-DWC forms, reports or records |
| 3296 | 5/15/2014 | MasTec, Inc. | Fined $15,310. | Failed to timely pay or deny medical bills and to accurately and/or timely submit reports to TDI/DWC |
| 3291 | 5/15/2014 | Pacific Employers Insurance Company | Fined $11,360 | Failed to accurately submit medical bill and payment data |
| 3294 | 5/15/2014 | St. Luke's Episcopal Health System | Fined $3,000 | Improperly billed an injured employee for workers’ compensation medical services provided |
| 3273 | 5/13/2014 | Ace Fire Underwriters Insurance Company | Fined $14,615 | Failed to accurately submit medical bill data; Failed to timely pay or deny medical bills; Failed to accurately and/or timely submit reports to TDI-DWC |
| 3272 | 5/13/2014 | Lowes Home Centers, Inc. | Fined $40,000 | Failed to timely pay or deny medical bills; Failed to accurately and/or timely submit reports to TDI-DWC |
| 3274 | 5/13/2014 | Segal, Andrew M.D. | Must not re-apply for designated doctor certification | Failed to timely file and/or accurately complete TDI-DWC forms, reports or records |
| 3253 | 4/29/2014 | Employers Compensation Insurance Company | Fined $1,125 | Failed to accurately submit medical bill and payment data |
| 3252 | 4/29/2014 | Fraser, Robert B., D.C. | Fined $3,500 | Failed to timely file and/or accurately complete TDI-DWC forms, reports or records |
| 3251 | 4/29/2014 | LM Insurance Corporation | Fined $56,000 | Failed to comply with requirements for income benefits initial payments and reporting |
| 3222 | 4/23/2014 | Amarillo I.S.D. | Fined $606 | Failed to accurately submit medical bill and payment data |
| 3226 | 4/23/2014 | East Texas Educational Insurance Association | Fined $6,372 | Failed to accurately submit medical bill and payment data |
| 3223 | 4/23/2014 | Hanover Lloyd's Insurance Company | Fined $2,132; Must conduct quarterly review of medical billing data submitted to TDI-DWC | Failed to accurately submit medical bill and payment data |
| 3224 | 4/23/2014 | LM Insurance Corporation | Fined $5,235 | Failed to timely pay income benefits to injured employee; Failed to accurately submit medical bill and payment data |
| 3225 | 4/23/2014 | Mahon-Deri, Brenda Marie M.D. | Fined $1,000 | Failed to maintain accurate records of designated doctor examination for required minimum time period |
| 3227 | 4/23/2014 | OneBeacon Insurance Company, as successor in interest to Houston General Insurance Company | Fined $4,050 | Failed to accurately submit medical bill and payment data |
| 3228 | 4/23/2014 | Ysleta I.S.D, | Fined $1,040 | Failed to accurately submit medical bill and payment data |
| 3219 | 4/21/2014 | Allmerica Financial Benefit Insurance Company | Fined $2,140; Must conduct quarterly review of medical billing data submitted to TDI-DWC | Failed to accurately submit medical bill and payment data |
| 3215 | 4/21/2014 | Massachusetts Bay Insurance Company | Fined $2,089 | Failed to timely pay income benefits to injured employee; |
| 3218 | 4/21/2014 | Peerless Insurance Company | Fined $15,500 | Failed to timely pay medical bill or to pay medical bill according to TDI-DWC Medical Fee Guidelines; Failed to accurately submit medical bill and payment data |
| 3216 | 4/21/2014 | Texas Mutual Insurance Company | Fined $32,048; Must conduct quarterly review of medical billing data submitted to TDI-DWC | Failed to accurately submit medical bill and payment data |
| 3220 | 4/21/2014 | The Hanover Insurance Company | Fined $2,109; Must conduct quarterly review of medical billing data submitted to TDI-DWC | Failed to accurately submit medical bill and payment data |
| 3217 | 4/21/2014 | Thompson, Daniel O. III, M.D. | Fined $3,600 | Improperly refused an appointment to perform a subsequent designated doctor examination of injured employee |
| 3211 | 4/17/2014 | GuideOne Elite Insurance Company | Fined $4,042 | Failed to accurately submit medical bill and payment data |
| 3213 | 4/17/2014 | Pacific Indemnity Company | Fined $3,123 | Failed to timely pay income benefits to injured employee; |
| 3210 | 4/17/2014 | Property & Casualty Insurance Company of Hartford | Fined $3,104 | Failed to accurately submit medical bill and payment data |
| 3212 | 4/17/2014 | Safety National Casualty Corporation | Fined $32,109 | Failed to accurately submit medical bill and payment data; Failed to timely pay income benefits to injured employee; Failed to timely pay benefits to injured employee per designated doctors report |
| 3201 | 4/15/2014 | American Guarantee and Liability Insurance Company | Fined $1,095 | Failed to accurately submit medical bill and payment data |
| 3202 | 4/15/2014 | American Zurich Insurance Company | Fined $16,514 | Failed to accurately submit medical bill and payment data; Failed to timely act on a properly completed medical bill |
| 3200 | 4/15/2014 | Cho, Sung-Joon M.D. | Fined $1,500 | Improperly refused an appointment to perform a subsequent designated doctor examination of injured employee |
| 3203 | 4/15/2014 | Zurich American Insurance Company | Fined $47,735 | Failed to accurately submit medical bill and payment data; Failed to timely act on a properly completed medical bill; Failed to timely pay benefits to injured employee; Failed to notify TDI-DWC and injured employee of action taken on a claim; Failed to timely report initial payment of indemnity benefits to TDI-DWC |
| 3196 | 4/9/2014 | American Casualty Company of Reading, Pennsylvania | Fined $7,312 | Failed to accurately submit medical bill and payment data |
| 3180 | 4/9/2014 | City of McAllen | Fined $1,804 | Failed to accurately submit medical bill and payment data |
| 3186 | 4/9/2014 | Clarendon National Insurance Company | Fined $4,053 | Failed to accurately submit medical bill and payment data |
| 3185 | 4/9/2014 | Commerce and Industry Insurance Company | Fined $5,800 | Failed to timely pay benefits to injured employee; Failed to notify TDI-DWC and injured employee of actions taken on a claim |
| 3195 | 4/9/2014 | Continental Casualty Company | Fined $9,324 | Failed to timely pay properly completed medical bill received from health care provider; Failed to accurately submit medical bill and payment data |
| 3179 | 4/9/2014 | Harris County | Fined $1,985 | Failed to accurately submit medical bill and payment data |
| 3191 | 4/9/2014 | Hartford Casualty Insurance Company | Fined $6,662 | Failed to accurately submit medical bill and payment data; Failed to timely perform a mandatory on-site visit for policyholder |
| 3190 | 4/9/2014 | Hartford Fire Insurance Company | Fined $3,618 | Failed to accurately submit medical bill and payment data; Failed to timely pay benefits to injured employee; Failed to timely perform on-site visit for policyholder |
| 3189 | 4/9/2014 | Hartford Insurance Company of the Midwest | Fined $11,460 | Failed to accurately submit medical bill and payment data; Failed to accurately pay benefits; Failed to accurately report claims data |
| 3188 | 4/9/2014 | Hartford Underwriters Insurance Company | Fined $3,383 | Failed to accurately submit medical bill and payment data |
| 3194 | 4/9/2014 | National Fire Insurance Company of Hartford | Fined $3,382 | Failed to accurately submit medical bill and payment data |
| 3184 | 4/9/2014 | The Phoenix Insurance Company | Fined $10,628 | Failed to accurately submit medical bill and payment data; Failed to timely act on request for reconsideration; Failed to timely pay benefits per designated doctors report |
| 3181 | 4/9/2014 | The Standard Fire Insurance Company | Fined $9,795 | Failed to accurately submit medical bill and payment data; Failed to timely act on a request for reconsideration; Failed to timely pay benefits per designated doctor report |
| 3182 | 4/9/2014 | The Travelers Indemnity Company | Fined $19,442 | Failed to accurately submit medical bill and payment data; Failed to timely pay benefits per designated doctors report |
| 3192 | 4/9/2014 | Transportation Insurance Company | Fined $4,593 | Failed to accurately submit medical bill and payment data |
| 3188 | 4/9/2014 | Travelers Property and Casualty Company of America | Fined $17,012 | Failed to accurately submit medical EDI records to TDI-DWC |
| 3183 | 4/9/2014 | Travelers Property and Casualty Company of America | Fined $17,012 | Failed to accurately and timely submit income benefit data; Failed to accurately submit medical bill and payment data; Failed to timely respond to a request for reconsideration |
| 3193 | 4/9/2014 | Twin City Fire Insurance Company | Fined $5,079 | Failed to accurately submit medical bill and payment data; Failed to timely pay benefits |
| 3187 | 4/9/2014 | Valley Forge Insurance Company | Fined $2,055 | Failed to accurately submit medical bill and payment data |
| 3169 | 4/2/2014 | Sam Kane Beef Processors, Inc. | Fined $3,031 | Failed to accurately submit medical bill and payment data |
| 3158 | 3/28/2014 | Benchmark Insurance Company | Fined $7,048 | Failed to accurately submit medical bill and payment data |
| 3167 | 3/28/2014 | Centre Insurance Company | Fined $4,106 | Failed to accurately submit medical bill and payment data |
| 3166 | 3/28/2014 | City of El Paso | Fined $2,163 | Failed to accurately submit medical bill and payment data |
| 3163 | 3/28/2014 | City of Lewisville | Fined $19,000 | Failed to timely act on a properly completed medical bill; Failed to accurately submit medical bill and payment data; Failed to timely notify TDI-DWC of request for independent review |
| 3164 | 3/28/2014 | Companion Property & Casualty | Fined $3,233 | Failed to accurately submit medical bill and payment data |
| 3157 | 3/28/2014 | Dallas Area Rapid Transit | Fined $1,380 | Failed to accurately submit medical bill and payment data |
| 3165 | 3/28/2014 | Dallas I.S.D. | Fined $13,103 | Failed to accurately submit medical bill and payment data; Failed to timely pay income benefits to injured employee; Failed to timely notify TDI-DWC and injured employee of actions taken on a claim; Failed to timely report initial payment of income benefits |
| 3159 | 3/28/2014 | Dolgencorp of Texas, Inc. | Fined $6,000 | Failed to accurately submit medical bill and payment data; Failed to timely act on a properly completed medical bill |
| 3154 | 3/28/2014 | Fairmont Insurance Company | Fined $7,078 | Failed to accurately submit medical bill and payment data |
| 3150 | 3/28/2014 | Farmers Insurance Exchange | $4,066 | Failed to accurately submit medical bill and payment data |
| 3161 | 3/28/2014 | Freestone Insurance Company | Fined $8,619 | Failed to accurately submit medical bill and payment data |
| 3151 | 3/28/2014 | Mid-Century Insurance Company | Fined $3,532 | Failed to accurately submit medical bill and payment data |
| 3160 | 3/28/2014 | Nationwide Agribusiness Insurance Company | Fined $1,164 | Failed to accurately submit medical bill and payment data |
| 3152 | 3/28/2014 | Star Insurance Company | Fined $1,423 | Failed to accurately submit medical bill and payment data |
| 3162 | 3/28/2014 | Stephens, Joseph W., III, M.D. | Fined $1,000 | Failed to maintain accurate records of designated doctor examination for required length of time |
| 3155 | 3/28/2014 | TIG Insurance Company | Fined $7,007 | Failed to accurately submit medical bill and payment data |
| 3156 | 3/28/2014 | TIG Insurance Company of Texas | Fined $7,040 | Failed to accurately submit medical bill and payment data |
| 3153 | 3/28/2014 | Truck Insurance Exchange | Fined $4,712 | Failed to accurately submit medical bill and payment data |
| 3139 | 3/21/2014 | Anderson, Mikel J. D.C. | Must complete medical documentation courses | Administered improper or unreasonable treatment or services; Created treatment plan which did not enhance ability of injured employee to return to work; Failed to maintain efficient utilization of health care |
| 3140 | 3/21/2014 | Fort Bend County | Fined $6,000 | Failed to accurately submit medical bill and payment data |
| 3131 | 3/19/2014 | Bituminous Casualty Corporation | Fined $6,591 | Failed to accurately submit medical bill and payment data |
| 3130 | 3/19/2014 | Bituminous Fire and Marine Insurance Company | Fined $6,373 | Failed to accurately submit medical bill and payment data |
| 3117 | 3/19/2014 | Church Mutual Insurance Company | Fined $407 | Failed to accurately submit medical bill and payment data |
| 3115 | 3/19/2014 | Discover Property and Casualty Insurance Company | Fined $4,139 | Failed to accurately submit medical bill and payment data |
| 3119 | 3/19/2014 | E.I. du Pont deNemours and Company | Fined $10,000 | Failed to accurately submit medical bill and payment data |
| 3132 | 3/19/2014 | El Paso County | Fined $4,812 | Failed to accurately submit medical bill and payment data |
| 3114 | 3/19/2014 | Farmington Casualty Company | Fined $1,184 | Failed to accurately submit medical bill and payment data |
| 3123 | 3/19/2014 | Fidelity and Guaranty Insurance Company | Fined $11,744 | Failed to accurately submit medical bill and payment data |
| 3134 | 3/19/2014 | Fireman's Fund Insurance Company | Fined $3,262 | Failed to accurately submit medical bill and payment data |
| 3124 | 3/19/2014 | Great Midwest Insurance Company | Fined $4,280 | Failed to accurately submit medical bill and payment data |
| 3133 | 3/19/2014 | Middlesex Insurance Company | Fined $783 | Failed to accurately submit medical bill and payment data |
| 3136 | 3/19/2014 | National Surety Corporation | Fined $1,292 | Failed to accurately submit medical bill and payment data |
| 3111 | 3/19/2014 | Old Republic Insurance Company | Fined $15,905 | Failed to accurately submit medical bill and payment data; Suspended income benefits for injured employee without providing explanation |
| 3113 | 3/19/2014 | Panzarella, Robert L., M.D. | Fined $3,000; Must remove designated doctor examination sites from TDI-DWC profile | Performed designated doctor examinations in facilities not used or properly equipped for medical examinations |
| 3135 | 3/19/2014 | Seabright Insurance Company | Fined $39,000 | Failed to timely act on a properly completed medical bill; Failed to timely and accurately submit medical bill and payment data |
| 3129 | 3/19/2014 | Sentry Insurance A Mutual Company | Fined $17,731 | Failed to timely pay income benefits to injured employee; Failed to notify TDI-DWC of actions taken on a claim; Failed to accurately submit medical bill and payment data |
| 3125 | 3/19/2014 | Southern Insurance Company | Fined $1,183 | Failed to accurately submit medical bill and payment data |
| 3137 | 3/19/2014 | Springfield Insurance Company | Fined $4,113 | Failed to accurately submit medical bill and payment data |
| 3122 | 3/19/2014 | St. Paul Fire and Marine Insurance Company | Fined $2,343 | Failed to accurately submit medical bill and payment data |
| 3127 | 3/19/2014 | St. Paul Mercury Insurance Company | Fined $704 | Failed to accurately submit medical bill and payment data |
| 3126 | 3/19/2014 | The American Insurance Company | Fined $1,589 | Failed to accurately submit medical bill and payment data |
| 3120 | 3/19/2014 | The Charter Oak Fire Insurance Company | Fined $1,561 | Failed to accurately submit medical bill and payment data |
| 3112 | 3/19/2014 | The Travelers Indemnity Company of America | Fined $2,638 | Failed to accurately submit medical bill and payment data; Failed to take final action on a medical bill within 45 days |
| 3128 | 3/19/2014 | Travelers Casualty and Surety Company | Fined $1,369 | Failed to accurately submit medical bill and payment data |
| 3121 | 3/19/2014 | Travelers Casualty Insurance Company of America | Fined $832 | Failed to accurately submit medical bill and payment data |
| 3116 | 3/19/2014 | United States Fidelity and Guaranty Company | Fined $13,307 | Failed to accurately submit medical bill and payment data |
| 3118 | 3/19/2014 | Winn Dixie Louisiana Inc. | Fined $4,121 | Failed to accurately submit medical bill and payment data |
| 3099 | 3/12/2014 | Dallas County | Fined $1,807 | Failed to accurately submit medical bill and payment data |
| 3100 | 3/12/2014 | VIA Metropolitan Transit | Fined $1,587 | Failed to accurately submit medical bill and payment data |
| 3096 | 3/11/2014 | Bancinsure Inc. | Fined $4,125 | Failed to accurately submit medical bill and payment data |
| 3081 | 3/11/2014 | Costello, James H., D.C. | Must complete complete medical record and documentation training and medical disability guide training | Utilized a treatment plan for injured employee that included unreasonable, unnecessary or unjustified number of procedures per office visit; Provided treatment plan that did not promote recovery or allow return to work |
| 3094 | 3/11/2014 | Employers Assurance Company | Fined $5,626 | Failed to accurately submit medical bill and payment data; Failed to timely pay income benefits to injured employee; Failed to timely report initial payment of indemnity benefits to TDI-DWC |
| 3080 | 3/11/2014 | Employers Preferred Insurance Company | Fined $626 | Failed to accurately submit medical bill and payment data |
| 3082 | 3/11/2014 | Helsten, Robert Allen M.D. | Fined $1,000; Must complete one-day designated doctor workshop | Medical records did not support scope of compensable injury; Failed to correctly apply AMA guidelines to assign impairment rating |
| 3095 | 3/11/2014 | Midwest Employers Casualty Company | Fined $3,469 | Failed to accurately submit medical bill and payment data |
| 3087 | 3/11/2014 | Mitsui Sumitomo Insurance Company of America | Fined $5,977 | Failed to accurately submit medical bill and payment data |
| 3086 | 3/11/2014 | Mitsui Sumitomo Insurance USA, Inc. | Fined $4,188 | Failed to accurately submit medical bill and payment data |
| 3079 | 3/11/2014 | Security National Insurance Company | Fined $3,097 | Failed to accurately submit medical bill and payment data |
| 3097 | 3/11/2014 | State Farm Fire and Casualty Company | Fined $4,500 | Failed to timely pay or deny medical bills and to accurately and/or timely submit reports to TDI-DWC |
| 3098 | 3/11/2014 | Tarrant County Hospital District | Fined $21,000 | Failed to accurately and timely submit medical bill and payment data; Failed to timely pay, reduce, deny or determine to audit a properly completed medical bill |
| 3085 | 3/11/2014 | Trinity Universal Insurance Company | Fined $3,076 | Failed to accurately submit medical bill and payment data |
| 3088 | 3/11/2014 | XL Specialty Insurance Company | Fined $4,151 | Failed to accurately submit medical bill and payment data |
| 3056 | 3/5/2014 | Arrowood Indemnity Company | Fined $1,034 | Failed to accurately submit medical bill and payment data |
| 3068 | 3/5/2014 | Association Casualty Insurance Company | Fined $16,500 | Failed to accurately and timely submit medical bill and payment data; Failed to timely pay, reduce, deny or to determine to audit a properly completed medical bill |
| 3058 | 3/5/2014 | Central Mutual Insurance Company | Fined $4,038 | Failed to accurately submit medical bill and payment data |
| 3055 | 3/5/2014 | Chubb Indemnity Company | Fined $5,725.30 | Failed to accurately submit medical bill and payment data |
| 3061 | 3/5/2014 | Federal Insurance Company | Fined $37,597 | Failed to accurately submit medical bill and payment data; Failed to timely process and take final action on a properly completed medical bill; Failed to timely report initial payment of indemnity benefits to TDI-DWC |
| 3064 | 3/5/2014 | FedEx Ground Package System Inc. | Fined $813 | Failed to accurately submit medical bill and payment data |
| 3069 | 3/5/2014 | Frisco I.S.D. | Fined $1,040 | Failed to accurately submit medical bill and payment data |
| 3053 | 3/5/2014 | Great Northern Insurance Company | Fined $4,286.80 | Failed to accurately submit medical bill and payment data |
| 3063 | 3/5/2014 | Old Republic General Insurance Corporation | Fined $1,316 | Failed to accurately submit medical bill and payment data |
| 3054 | 3/5/2014 | Pharmacists Mutual Insurance Company | Fined $4,090 | Failed to accurately submit medical bill and payment data |
| 3065 | 3/5/2014 | Prasad, A.R.S., M.D. | Fined $1,000; Must complete 8 hours continuing medical education | Failed to practice medicine or provide health care in acceptable manner consistent with public health, safety and welfare; Failed to document an injury to justify ongoing treatments and medications |
| 3059 | 3/5/2014 | Protective Insurance Company | Fined $10,965 | Failed to accurately submit medical bill and payment data; Failed to timely pay or deny medical bills and to accurately and/or timely submit reports to TDI-DWC |
| 3060 | 3/5/2014 | Service Lloyds Insurance Company | Fined $10,783 | Failed to accurately submit medical bill and payment data |
| 3062 | 3/5/2014 | Sompo Japan Insurance Company of America | Fined $1,220 | Failed to accurately submit medical bill and payment data |
| 3057 | 3/5/2014 | Texas Builders Insurance Company | Fined $3,866 | Failed to accurately submit medical bill and payment data |
| 3066 | 3/5/2014 | Textron, Inc. | Fined $1,370 | Failed to accurately submit medical bill and payment data |
| 3067 | 3/5/2014 | United States Fire Insurance Company | Fined $2,149 | Failed to accurately submit medical bill and payment data |
| 3032 | 2/25/2014 | TASB Risk Management Fund | Fined $16,124; Must conduct quarterly self audits during calendar year 2014 and submit first report to TDI-DWC by March 31, 2014 | Submitted inaccurate medical billing data to TDI-DWC |
| 3030 | 2/24/2014 | America First Lloyd's Insurance Company | Fined $2,683 | Submitted inaccurate medical billing data to TDI-DWC |
| 3027 | 2/21/2014 | ACIG Insurance Company | Fined $4,928 | Submitted inaccurate medical billing data to TDI-DWC |
| 3029 | 2/21/2014 | City of San Antonio | Fined $3,964 | Submitted inaccurate medical billing data to TDI-DWC |
| 3026 | 2/21/2014 | Meridian Security Insurance Company | Fined $4,147 | Submitted inaccurate medical billing data to TDI-DWC |
| 3028 | 2/21/2014 | Netherlands Insurance Company | Fined $6,801 | Submitted inaccurate medical billing data to TDI-DWC |
| 3025 | 2/20/2014 | OneBeacon Insurance Company | Fined $1,093 | Submitted inaccurate medical bill data to TDI-DWC |
| 3015 | 2/14/2014 | Alaska National Insurance Company | Fined $5,110 | Submitted inaccurate medical bill data to TDI-DWC <br /> |
| 3013 | 2/14/2014 | Dilger, J. Thomas, Jr., M.D. | Must not re-apply for designated doctor certification in the Texas workers' compensation system | Assigned impairment ratings that failed to comply with medical guidelines; Failed to document objective medical evidence and/or an analysis of evidence to support conclusions on designated doctor questions; Failed to perform adequate examination; Failed to obtain complete set of medical records <br /> |
| 3018 | 2/14/2014 | Hyatt Corp. | Fined $880.50 | Submitted inaccurate medical bill data to TDI-DWC |
| 3017 | 2/14/2014 | Mesquite I.S.D. | Fined $1,172 | Submitted inaccurate medical bill data to TDI-DWC <br /> |
| 3014 | 2/14/2014 | National American Insurance Company | Fined $5,122 | Submitted inaccurate medical bill data to TDI-DWC <br /> |
| 3019 | 2/14/2014 | Praetorian Insurance Company | Fined $20,000 | Failed to timely pay medical bill; Failed to timely submit medical bill and payment data to TDI-DWC; Failed to accurately submit medical EDI records to TDI-DWC <br /> |
| 3016 | 2/14/2014 | T.H.E. Insurance Company | Fined $4,146 | Submitted inaccurate medical bill data to TDI-DWC <br /> |
| 3012 | 2/14/2014 | Zenith Insurance Company | Fined $3,827 | Submitted inaccurate medical bill data to TDI-DWC <br /> |
| 2999 | 2/12/2014 | Marioni, Luis, D.C. | Fined $2,500; Must complete online medical education course within 180 days; Must attend medical record documentation course; Must submit documentation of continuing medical education completed for medical license renewal | Administered improper, unreasonable or medically unnecessary treatment and services; Failed to document rationale for not following medical guidelines; Failed to comply with commissioner rule <br /> |
| 2987 | 1/31/2014 | Meyer, Ralph C., D.C. | Fined $2,500 | Failed to maintain efficient utilization of health care by ordering unnecessary diagnostic testing, prescribing excessive amounts of physical therapy and scheduling unnecessary office visits <br /> |
| 2985 | 1/31/2014 | Myles, Robert Tytan, M.D. | Permanently removed from Texas workers' compensation system as a health care provider | Performed two surgical procedures that were unreasonable and medically unnecessary because procedures not justified by sufficient medical evidence <br /> |
| 2986 | 1/31/2014 | Pennsylvania Manufacturers' Association Insurance Company | Fined $1,288 | Submitted inaccurate medical bill data to TDI-DWC <br /> |
| 2984 | 1/31/2014 | Travis County | Fined $734 | Submitted inaccurate medical bill data to TDI-DWC |
| 2949 | 1/10/2014 | Texas Mutual Insurance Company | Fined $2,000 | Failed to timely pay income benefits to injured employee; Failed to pay correct amount of income benefits to injured employee; Failed to timely notify TDI-DWC of payment change <br /> |