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Texas: Division addresses medical dispute resolution
The Division of Workers' Compensation proposed amendments to rules regarding medical dispute resolution and the arbitration of medical fee dispute cases.
The rules state that a request for medical fee dispute resolution that involves a first responder's request for reimbursement of medical expenses paid will be accelerated by the division and given first priority. The rule also lists the requirements to make a request for medical fee dispute resolution and the procedures to appeal a medical fee dispute resolution decision. The rules establish an arbitration process for appeals of medical fee dispute resolution cases. The rule clarifies that the statement of dispute in the arbitration of a medical fee dispute cannot include a dispute regarding compensability, extent of injury, liability, or medical necessity for the service for which there is a medical fee dispute. The division also proposed revisions to forms related to medical fee dispute resolution to conform to the proposed rules and to implement legislative changes. The division scheduled a public hearing on April 13 and accepted comments until April 23. Read more at the WorkersComp Forum homepage.
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