State News : Texas

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On 8/18/17, DWC posted changes to the Designated Doctor Rules and asked system participants for informal comments.  The stated reason for the changes is to “simplify certain DD 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. 
The DWC Designated Doctor List (DDL) has undergone significant demographic changes since Rule 127 was adopted in September of 2012.  Specifically, there are half as many doctors on the DDL and there has been a dramatic decrease in the number of medical doctors on the DDL, while the number of chiropractors has steadily increased.  Of the 540 total doctors on the DDL, 167 of them are medical doctors and 352 are chiropractors.  When Rule 127 was adopted, there were 1247 doctors on the DDL, 929 of whom were medical doctors and 203 were chiropractors.
In an effort to keep designated doctors in the program, and ostensibly to lure more medical doctors back to the fold, the DWC is proposing changes to the selection and qualification criteria that would allow more examinations per appointment and more specialization (in other words, more exams for medical doctors and doctors of osteopathy) for more complex injuries, which have been further defined by the proposed rules.  The current selection process “penalizes” the more specialized doctors by moving them to the bottom of the appointment list when appointed to complex cases.
Of interest is the fact that the DWC has not addressed any increase in the fee schedule to take into account changes in the complexity of the system, the Designated Doctor rules and the kinds of examinations designated doctors are appointed to address.
The informal comment period closes on 9/1/17, but the rules will be posted for formal comment.