Texas Register, Volume 37, Number 30, Pages 5519-5676, July 27, 2012 Page: 5,558
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Arbiter would be ineligible from sitting on the ISC for the subject the
Arbiter reviewed.
180.64. MQRP Application Process.
(a) To apply to the MQRP, a person must submit an application
in the form and manner required by the division demonstrating com-
pliance with the required qualifications. The application must contain
complete information as provided by subsection (b) of this section. The
medical advisor may select and appoint only qualified applicants to the
division's MQRP but are not required to accept all applicants who meet
the requirements specified in this subchapter.
(b) The division's required application form for the MQRP, at
a minimum, shall include:
(1) contact information for the health care practitioner;
(2) information about the health care practitioner's educa-
tion;
(3) a description of the health care practitioner's license(s),
certifications, and professional specialty, if any;
(4) a description of the health care practitioner's work his-
tory and hospital or other health care practitioner affiliations;
(5) a description of any affiliations the health care practi-
tioner has with a workers' compensation health care network certified
under Chapter 1305 of the Insurance Code or a political subdivision as
described in Labor Code 504.053(b)(2);
(6) identification of and a description of all current and past
medical review affiliations, including but not limited to an independent
review organization (IRO), utilization review agent (URA), licensing
board, and insurance carrier;
(7) information regarding the health care practitioner's cur-
rent practice locations;
(8) disclosure regarding the health care practitioner's pro-
fessional background, education, training, and fitness to perform the
duties of an MQRP member, including disclosure of any disciplinary
actions or other sanctions taken against the health care practitioner by
any state licensing board, state or federal agency, and hospital or other
health care institution, as well as disclosure of any voluntary relinquish-
ments, drug and alcohol misuse, malpractice claims history and crimi-
nal history;
(9) a description of all ownership interests or other finan-
cial arrangements, such as salaried or contract employment, involving
a person or their agent subject to the Act or a rule, order, or decision of
the commissioner;
(10) an authorization for third parties to release informa-
tion relevant to the verification of the information provided on the ap-
plication to the division;
(11) an affirmation that all information provided in the ap-
plication is accurate and complete to the best of the health care practi-
tioner's knowledge; and
(12) an affirmation of understanding of the legal require-
ments, including confidentiality provisions, for MQRP members.
(c) A credentialing application for hospital credentialing may
substitute for some items under subsection (b) of this section.
(d) The health care practitioner must inform the medical advi-
sor of any changes to this information within 30 days after the change.
(e) The application shall be reviewed by the medical advisor.(f) The medical advisor and the commissioner have the discre-
tion to select and appoint an applicant to the MQRP.
(g) Membership in the MQRP is for a term of two years. The
acceptance letter will include the effective date and expiration date.
(h) Membership in the MQRP is not a guarantee of any number
of assignments.
(i) MQRP members shall be entitled to compensation for work
assigned by the medical advisor at the following hourly rates:
(1) Doctors - Medical case reviews, ad hoc work groups,
or special projects: $150 per hour.
(2) Non-Doctors - Medical case reviews, ad hoc work
groups or special projects: $100 per hour.
(3) Limits on hours. A member shall not be paid for more
than:
(A) five hours for a medical case review of a single case;
(B) five hours for ad hoc work group or special project
service; or
(C) 20 hours in a given calendar month.
(4) The medical advisor may approve additional hours in
writing upon review of a submitted narrative report or a report of an ad
hoc work group.
(5) Hearings or trial preparation.
(A) Doctors - Payment for time spent in hearing or in
trial preparation, in providing testimony in deposition, hearing or trial:
$350 per hour.
(B) Non-doctors - Payment for time spent in hearing or
in trial preparation, in providing testimony in deposition, hearing or
trial: $175 per hour.
(C) An MQRP member shall not be paid for more than
eight hours per day for a deposition, a hearing, trial preparation or court
testimony. If travel is required, the division will pay the member for
travel, lodging and per diem expenses in accordance with the Texas
State Travel Management Program, 34 TAC 20.301 et seq.
(6) The division may vary the above reimbursement provi-
sions if deemed by the division to be in the best interests of the division
or the State of Texas.
(j) In accordance with Labor Code 402.083 - 402.086,
402.091, 402.092, and 413.0513, an MQRP member may not disclose
a report or other documentation prepared by the MQRP member for
the division.
(k) All reports and related documents, including electronic and
non-electronic data, prepared by or furnished to the member for the
MQRP, are the sole property of the division.
180.66. Medical Case Review.
The MQRP may perform medical case review for the medical advisor.
Medical case review may be performed for the purposes of the medical
quality review process, designated doctor certification and recertifica-
tion, performance based oversight, or any other medical case review
necessary to assist in performing the medical advisor's duties under the
Labor Code.
180.68. Medical Quality Review Process.
(a) The medical quality review process is medical case review
initiated on the basis of complaints, plan-based audits, or monitoring37 TexReg 5558 July 27, 2012 Texas Register
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Texas. Secretary of State. Texas Register, Volume 37, Number 30, Pages 5519-5676, July 27, 2012, periodical, July 27, 2012; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth243959/m1/40/: accessed March 19, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.