Texas Code § 413.0511

MEDICAL ADVISOR
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Sec. 413.0511. MEDICAL ADVISOR. (a) The division shall employ or contract with a medical advisor, who must be a doctor as that term is defined by Section 401.011 .
(b) The medical advisor shall make recommendations regarding the adoption of rules and policies to:
(1) develop, maintain, and review guidelines as provided by Section 413.011 , including rules regarding impairment ratings;
(2) review compliance with those guidelines;
(3) regulate or perform other acts related to medical benefits as required by the commissioner;
(4) impose sanctions or delete doctors from the division's list of approved doctors under Section 408.023 for:
(A) any reason described by Section 408.0231 ; or
(B) noncompliance with commissioner rules;
(5) impose conditions or restrictions as authorized by Section 408.0231 (f);
(6) receive, and share with the medical quality review panel established under Section 413.0512 , confidential information, and other information to which access is otherwise restricted by law, as provided by Sections 413.0512 , 413.0513 , and 413.0514 from the Texas State Board of Medical Examiners, the Texas Board of Chiropractic Examiners, or other occupational licensing boards regarding a physician, chiropractor, or other type of doctor who applies for registration or is registered with the division on the list of approved doctors;
(7) determine minimal modifications to the reimbursement methodology and model used by the Medicare system as necessary to meet occupational injury requirements; and
(8) monitor the quality and timeliness of decisions made by designated doctors and independent review organizations, and the imposition of sanctions regarding those decisions.

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