Texas Workers’ Compensation March Disciplinary Orders:
Ace American Insurance Company of Philadelphia, PA
Order Number: DWC-11-0028
Date of Order: 3/3/2011
Order Final In: March
Action Taken: Fined $48,000
Violation: Failed to comply with order or decision of Commissioner or TDI-DWC; Failed to timely pay income benefits to injured employee; Failed to pay for preauthorized medical services; Failed to timely act on request for reconsideration of a medical bill
American Home Assurance Company of New York, NY
Order Number: DWC-11-0032
Date of Order: 3/3/2011
Order Final In: March
Action Taken: Fined $11,000
Violation: Failed to pay for preauthorized medical services; Failed to timely respond to an injured employee’s request for reimbursement of travel expenses
Arch Insurance Company of Jersey City, NJ
Order Number: DWC-110030
Date of Order: 3/3/2011
Order Final In: March
Action Taken: Fined $4,500
Violation: Failed to timely pay income benefits to injured employee; Failed to timely pay medical bill; Failed to timely act on request for reconsideration of a medical bill
Begia, Bruce C., M.D. of San Antonio
Order Number: DWC110040
Date of Order: 3/11/2011
Order Final In: March
Action Taken: Fined $1,000; Must attend compliance training for doctors and medical staff
Violation: Failed to timely file and/or accurately complete TDI-DWC forms, reports or records
Bumagin, Michael S. M.D. of Fort Worth
Order Number: DWC110027
Date of Order: 3/3/2011
Order Final In: March
Action Taken: Removed from Designated Doctor List; Maximum Medical Improvement and Impairment Rating certifications revoked
Violation: Failed to assign Impairment Ratings in accordance with the American Medical Association Guides to Permanent Impairment
Crockett, James D.O. of Marlin
Order Number: DWC110043
Date of Order: 3/24/2011
Order Final In: March
Action Taken: Removed from participation in workers’ compensation system as health care provider for 10 years
Violation: Provided diagnoses and treatments found to be improper, unfair and/or unreasonable and not supported by documentation and/or physical examination of injured employee
Dallas National Insurance Company, A Texas Stock Insurance Company of Dallas
Order Number: DWC-110042
Date of Order: 3/22/2011
Order Final In: March
Action Taken: Fined $9,000
Violation: Failed to pay for preauthorized medical services; Failed to timely pay income benefits to injured employee
Davis, Carl Cuthbert Jr., M.D. of Houston
Order Number: DWC110031
Date of Order: 3/3/2011
Order Final In: March
Action Taken: Fined $1,250; Suspended from Designated Doctor’s List of 90 days; Must attend compliance training for doctors and medical staff
Violation: Failed to timely file letter of clarification; Failed to timely file and/or accurately complete TDI-DWC forms, reports or records
Hartford Fire Insurance Company of Hartford, CT
Order Number: DWC-110035
Date of Order: 3/3/2011
Order Final In: March
Action Taken: Fined $5,000
Violation: Failed to reasonably and prudently process claims ; Failed to provide written notification of claims experience; Failed to provide written notification of loss analysis; Failed to provide mandatory on-site visit to policyholders
Hartford Insurance Company of the Midwest of Hartford, CT
Order Number: DWC110034
Date of Order: 3/3/2011
Order Final In: March
Action Taken: Fined $4,500
Violation: Failed to timely pay income benefits to injured employee; Failed to provide written notification of claims experience
Horoda, Michael Johnathan, M.D. of Fort Worth
Order Number: DWC110029
Date of Order: 3/3/2011
Order Final In: March
Action Taken: Fined $3,000
Violation: Failed to timely file and/or accurately complete TDI-DWC forms, reports or records
Houston Northwest Emergency Specialists, PLLC of Houston
Order Number: DWC110039
Date of Order: 3/7/2011
Order Final In: March
Action Taken: Fined $4,000
Violation: Improperly billed an injured employee for workers’ compensation medical services provided
Moczygemba, Roger M., M.D. of San Antonio
Order Number: DWC-110041
Date of Order: 3/22/2011
Order Final In: March
Action Taken: Fined $3,000; Must attend compliance training for doctors and medical staff
Violation: Failed to timely file and/or accurately complete TDI-DWC forms, reports or records
Osborne, William (Phillip) M.D. of Houston
Order Number: DWC-110044
Date of Order: 3/24/2011
Order Final In: March
Action Taken: Fined $4,500; Must attend compliance training for doctors and medical staff
Violation: Failed to timely file and/or accurately complete TDI-DWC forms, reports or records
TASB Risk Management Fund of Austin
Order Number: DWC110036
Date of Order: 3/3/2011
Order Final In: March
Action Taken: Fined $5,000
Violation: Failed to timely pay income benefits to injured employee
Transportation Insurance Company of Chicago, IL
Order Number: DWC-110033
Date of Order: 3/3/2011
Order Final In: March
Action Taken: Fined $10,000
Violation: Retrospectively reviewed medical necessity of preauthorized medical service or treatment; Failed to pay for preauthorized medical services
Wan, Christine Wyman M.D. of Odessa
Order Number: DWC110037
Date of Order: 3/3/2011
Order Final In: March
Action Taken: Fined $1,000; Must attend compliance training for doctors and medical staff
Violation: Failed to timely file and/or accurately complete TDI-DWC forms, reports or records
Wolski, Edward, M.D. DBA Wol+Med of Denton
Order Number: DWC110038
Date of Order: 3/7/2011
Order Final In: March
Action Taken: Fined $5,000
Violation: Filed unwarranted complaints against system participants
Source: Texas Division of Workers’ Compensation
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