Texas Self-Insurance Association

Pursuant to new rules, Texas Administrative Code (TAC) Title 28, Chapter 133, Subchapter D (related to Dispute of Medical Bills), §§133.305, 133.307, and 133.308, IRO review and assignment functions have been consolidated within the HWCN Division of TDI.  Previously, IRO assignments related to the medical dispute resolution process for medical necessity were handled by the DWC.  These IRO assignments will transfer from the DWC to the HWCN Division effective January 15, 2007.  Section 133.308(a), related to medical dispute resolution (MDR) by IROs, provides that all IROs performing review of health care under the Labor Code and Insurance Code, regardless of where the independent review activities are located, shall comply with §133.308.  The new rules may be accessed on the TDI-DWC website at: http://www.tdi.state.tx.us/wc/rules/tableofcontents/rulesoptions.html.

See the attached bulletins for HCPs, URAs and IROs below.