Proposed New Changes to Designed Doctor Program Could Affect Chiropractic
Written by Editor   
Friday, May 18, 2018 12:00 AM

In August 2017, the Texas Department of Insurance – Division of Workers’ Compensation (DWC) published an informal draft rule amending procedures related to the Designated Doctor Program. The DWC’s stated objective with the informal draft rule was to “simplify certain [Designated Doctor] processes, retain and recruit doctors to continue to ensure the most optimally qualified doctor is selected for an examination, provide transparency, and allow for better monitoring of designated doctors.” In response to the informal draft rule, TCA submitted comments to the DWC expressing concerns that the informal draft rule prioritized one profession over another and restricted chiropractic scope of practice. TCA also had meetings and conversations with the DWC to share concerns about the potential impact the informal draft rule could have on both doctors of chiropractic (DCs) and injured workers.

On May 18, DWC published a rule proposal to amend procedures related to the Designated Doctor Program. The proposed rule is different from the informal draft rule the DWC published in August 2017, so TCA is currently analyzing the changes and the potential impact to DCs and injured workers. However, TCA understands some of the primary changes to include:

  • Transitioning from a single Designated Doctor list to a two-list model (i.e., one list of DCs, MDs and DOs for cases involving musculoskeletal issues, and a second list of MDs and DOs for non-musculoskeletal issues);
  • A change to distinguish "musculoskeletal structures of the torso" (assigned to doctors on the first list referenced above) and “non-musculoskeletal structures of the torso” (assigned to doctors on the second list referenced above); and
  • A change to place cauda equina syndrome under the types of cases that can be assigned only to doctors on the second list referenced above.

Again, TCA’s leadership continues to examine the impact of this proposed rule and intends to submit further comment to the DWC. For more information and to review the proposed rule, visit: http://www.sos.state.tx.us/texreg/archive/May182018/Proposed%20Rules/28.INSURANCE.html#39. Please note that any comments you would like to submit to the DWC concerning the proposed rule must be submitted by 5 p.m. CST June 18.