(a) Any of the following acts by a service provider constitutes a violation for which the service provider is subject to subsection (b) of this section:
- (1) submitting charges for services that were not furnished;
- (2) administering improper, unreasonable, or medically unnecessary treatment or service;
- (3) failing or refusing to timely file required reports or records upon request;
- (4) making unnecessary referrals for service;
- (5) violating the fee guidelines as established by the Texas Workers' Compensation Commission; or
- (6) failure to comply with any provision of the Texas Administrative Code, Title 1, Part III, Chapter 61, or Tex. Code Crim. Proc. Chapter 56.
- (b) A service provider that commits any of the violations in subsection (a) of this section is subject to a reduction or denial of payments, and any other applicable penalties allowed by law.
- (c) The OAG shall award compensation for out of state health care services according to the Texas Workers' Compensation Commission medical fee guidelines.
Source Note:The provisions of this §61.507 adopted to be effective December 15, 2002, 27 TexReg 11513.