Sunset Commission Issues TBCE Report – Issue 3
Written by Editor   
Sunday, October 09, 2016 12:02 PM

Issue 3 of the Sunset Commission’s Staff Report is the board lacks formal mechanisms to ensure chiropractic expertise in Its enforcement process.

“The Texas Board of Chiropractic Examiners needs the expertise of a trained, licensed chiropractor to determine whether chiropractic care meets appropriate professional standards. … Statute outlines requirements for local peer review committees throughout the state and an executive peer review committee responsible for reviewing cases not resolved at the local peer review committee level. …the board implemented an expert review process in February 2016. The board now contracts as needed with licensed chiropractors to offer expertise on chiropractic standard of care cases. The board’s expert review pool consists of four licensed chiropractors who are compensated $150 per case reviewed. Similar to standard of care cases, the board also contracts with two billing and coding experts to aid in determining the presence of billing fraud.

The statutory peer review committee structure was never fully implemented because it is too onerous to meet the board’s limited needs.  While the board made several attempts to implement the peer review committees provided in law, the committees never became fully functional and, as a result, have been inactive for years.”

While the board recently implemented an expert review process, it lacks formality and is not fully developed. …No statutory provisions, board rules, or formal policies exist to outline implementation requirements for the process. As such, the board lacks policies to define which types of complaints merit expert review, process or content requirements to ensure quality reviews, timely evaluations from experts, or provisions to protect the confidentiality of complainant and patient information. While the board could take some steps to formalize this process on its own, an agency should also have a clear legal authority for its operations.”

The Sunset Staff recommends several changes to the Chiropractic Act: “repeal the local and executive peer review requirements from statute. … Instead, the board would use the expert review process .... to obtain expert opinion on standard of care complaints.” 

They also recommend “require the board to develop an expert review process in rule to ensure chiropractic expertise in its enforcement process. This recommendation would require the board to develop an expert review process for investigating complaints that require additional expertise. … contract as needed with a pool of qualified experts to review cases to aid in the board’s investigation. The board should develop rules by March 1, 2018…”