Tex. Labor Code Section 413.05122
Medical Quality Review Panel: Rules; Training


(a)

The commissioner, after consultation with the medical advisor, shall adopt rules concerning the operation of the medical quality review panel, including rules that establish:

(1)

the qualifications necessary for a health care provider to serve on the medical quality review panel;

(2)

the composition of the medical quality review panel, including the number of members to be included on the panel and the health care specialty fields required to be represented by the members of the panel;

(3)

the maximum length of time a health care provider may serve on the medical quality review panel;

(4)

a policy defining situations that constitute a conflict of interest for a member of the medical quality review panel;

(5)

procedures and grounds for removing a member of the medical quality review panel from the panel, including as a ground for removal that a member is repeatedly delinquent in conducting case reviews; and

(6)

a procedure through which members of the medical quality review panel are notified concerning the status and enforcement outcomes of cases resulting from the medical quality review process.

(b)

In addition to the rules required under Subsection (a), the commissioner shall adopt rules concerning the training requirements for members of the medical quality review panel. The rules adopted under this subsection must ensure that panel members are fully aware of any requirements imposed by this subtitle concerning the medical quality review process and the division’s goals concerning the process. The rules adopted under this subsection may require members to receive training on any topic determined by the division or the commissioner to be relevant to the operations of the panel and must require members of the panel to receive training concerning:

(1)

administrative violations that affect the delivery of appropriate medical care;

(2)

the confidentiality requirements described by Section 413.0513 (Confidentiality Requirements) and the immunity from liability provided to members of the panel under Section 413.054 (Immunity from Liability); and

(3)

the medical quality review criteria adopted under Section 413.05115 (Medical Quality Review Process).
Added by Acts 2011, 82nd Leg., R.S., Ch. 1162 (H.B. 2605), Sec. 24, eff. September 1, 2011.

Source: Section 413.05122 — Medical Quality Review Panel: Rules; Training, https://statutes.­capitol.­texas.­gov/Docs/LA/htm/LA.­413.­htm#413.­05122 (accessed Jun. 5, 2024).

413.002
Medical Review
413.003
Authority to Contract
413.004
Coordination with Providers
413.006
Advisory Committees
413.007
Information Maintained by Division
413.008
Information from Insurance Carriers
413.011
Reimbursement Policies and Guidelines
413.012
Medical Policy and Guideline Updates Required
413.013
Programs
413.014
Preauthorization Requirements
413.015
Payment by Insurance Carriers
413.016
Payments in Violation of Medical Policies and Fee Guidelines
413.017
Presumption of Reasonableness
413.018
Review of Medical Care if Guidelines Exceeded
413.019
Interest Earned for Delayed Payment, Refund, or Overpayment
413.020
Division Charges
413.021
Return-to-work Coordination Services
413.022
Return-to-work Reimbursement Program for Employers
413.023
Information to Employers
413.024
Information to Employees
413.025
Return-to-work Goals and Assistance
413.031
Medical Dispute Resolution
413.032
Independent Review Organization Decision
413.041
Disclosure
413.042
Private Claims
413.043
Overcharging Prohibited
413.044
Sanctions on Designated Doctor
413.051
Contracts with Review Organizations and Health Care Providers
413.052
Production of Documents
413.053
Standards of Reporting and Billing
413.054
Immunity from Liability
413.055
Interlocutory Orders
413.0111
Processing Agents
413.0112
Reimbursement of Federal Military Treatment Facility
413.0115
Requirements for Certain Voluntary or Informal Networks
413.0141
Initial Pharmaceutical Coverage
413.0311
Review of Medical Necessity Disputes
413.0312
Review of Medical Fee Disputes
413.0511
Medical Advisor
413.0512
Medical Quality Review Panel
413.0513
Confidentiality Requirements
413.0514
Information Sharing with Occupational Licensing Boards
413.0515
Reports of Chiropractor Violations
413.05115
Medical Quality Review Process
413.05121
Quality Assurance Panel
413.05122
Medical Quality Review Panel: Rules

Accessed:
Jun. 5, 2024

§ 413.05122’s source at texas​.gov