CHAPTER 414. ENFORCEMENT OF COMPLIANCE AND PRACTICE REQUIREMENTS
LABOR CODE
TITLE 5. WORKERS' COMPENSATION
SUBTITLE A. TEXAS WORKERS' COMPENSATION ACT
CHAPTER 414. ENFORCEMENT OF COMPLIANCE AND PRACTICE REQUIREMENTS
Sec. 414.002. MONITORING DUTIES. (a) The division shall
monitor for compliance with commissioner rules, this subtitle,
and other laws relating to workers' compensation the conduct of
persons subject to this subtitle. Persons to be monitored
include:
(1) persons claiming benefits under this subtitle;
(2) employers;
(3) insurance carriers;
(4) attorneys and other representatives of parties; and
(5) health care providers.
(b) The division shall monitor conduct described by Sections
415.001, 415.002, and 415.003 and refer persons engaging in that
conduct to the division of hearings.
(c) The division shall monitor payments made to health care
providers on behalf of workers' compensation claimants who
receive medical services to ensure that the payments are made on
time as required by Section 408.027.
Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.
Amended by:
Acts 2005, 79th Leg., Ch.
265, Sec. 3.260, eff. September 1, 2005.
Sec. 414.003. COMPILATION AND USE OF INFORMATION. (a) The
division shall compile and maintain statistical and other
information as necessary to detect practices or patterns of
conduct by persons subject to monitoring under this chapter that:
(1) violate this subtitle, commissioner rules, or a commissioner
order or decision; or
(2) otherwise adversely affect the workers' compensation system
of this state.
(b) The commissioner shall use the information compiled under
this section to impose appropriate penalties and other sanctions
under Chapters 415 and 416.
Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.
Amended by:
Acts 2005, 79th Leg., Ch.
265, Sec. 3.261, eff. September 1, 2005.
Sec. 414.004. PERFORMANCE REVIEW OF INSURANCE CARRIERS. (a)
The division shall review regularly the workers' compensation
records of insurance carriers as required to ensure compliance
with this subtitle.
(b) Each insurance carrier, the carrier's agents, and those with
whom the carrier has contracted to provide, review, or monitor
services under this subtitle shall:
(1) cooperate with the division;
(2) make available to the division any records or other
necessary information; and
(3) allow the division access to the information at reasonable
times at the person's offices.
(c) The insurance carrier, other than a governmental entity,
shall pay the reasonable expenses, including travel expenses, of
an auditor who audits the workers' compensation records at the
office of the insurance carrier.
Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.
Sec. 414.005. INVESTIGATION UNIT. The division shall maintain
an investigation unit to conduct investigations relating to
alleged violations of this subtitle, commissioner rules, or a
commissioner order or decision, with particular emphasis on
violations of Chapters 415 and 416.
Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.
Amended by:
Acts 2005, 79th Leg., Ch.
265, Sec. 3.262, eff. September 1, 2005.
Sec. 414.006. REFERRAL TO OTHER AUTHORITIES. For further
investigation or the institution of appropriate proceedings, the
division may refer the persons involved in a case subject to an
investigation to other appropriate authorities, including
licensing agencies, district and county attorneys, or the
attorney general.
Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.
Amended by:
Acts 2005, 79th Leg., Ch.
265, Sec. 3.263, eff. September 1, 2005.
Sec. 414.007. MEDICAL REVIEW. The division shall review
information concerning alleged violations of this subtitle
regarding the provision of medical benefits, commissioner rules,
or a commissioner order or decision, and, under Sections 414.005
and 414.006 and Chapters 415 and 416, may conduct investigations,
make referrals to other authorities, and initiate administrative
violation proceedings.
Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.
Amended by:
Acts 2005, 79th Leg., Ch.
265, Sec. 3.264, eff. September 1, 2005.