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§ 134.201. Medical Fee Guideline for Medical Treatments and Services Provided under the Texas Workers’ Compensation Act

(a) The commission adopts by reference herein, the Texas Workers’ Compensation Commission Medical Fee Guideline 1996. The Guideline shall be effective for all medical treatments, services, durable medical equipment and pharmaceuticals provided on or after April 1, 1996. Medical treatments, services, and durable medical equipment provided prior to April 1, 1996, shall be subject to the 1991 Texas Workers’ Compensation Commission Medical Fee Guideline (December 1991 Version). Pharmaceuticals provided prior to April 1, 1996, shall be subject to § 134.501 of this title (relating to the Pharmaceutical Fee Guideline). Copies of both guidelines may be obtained from the Publication Department of the Texas Workers’ Compensation Commission, 4000 South IH-35, Southfield Building, Austin, Texas 78704.

(b) An insurance carrier or health care provider which willfully or intentionally violates the provisions of this rule commits an administrative violation under Texas Labor Code, § 415.002 or § 415.003, and may be assessed a penalty. In addition, an insurance carrier or health care provider which repeatedly violates these statutory provisions may be assessed a penalty not to exceed $10,000 under the Texas Labor Code, § 415.021, and may be subject to the sanctions specified in the Texas Labor Code, § 415.023, including, but not limited to, restriction or revocation of the right to receive reimbursement under the Texas Workers’ Compensation Act.

The provisions of this § 134.201 adopted to be effective April 1, 1996, 21 TexReg 2361.

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At a Glance:

Title:

§ 134.201. Medical Fee Guideline for Medical Treatments and Services Provided under the Texas Workers’ Compensation Act

Title:

Title 28. Insurance

Status:

Current

Usage:

New Law Rule

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