16 Tex. Admin. Code § 130.41
Reporting Medical Professional Liability Claims
Effective Jul 5, 200631 TexReg 5289 Source Note: The provisions of this §130.41 adopted to be effective July 5, 2006, 31 TexReg 5289; transferred effective September 1, 2017, as published in the Texas Register August 18, 2017, 42 TexReg 4145. Texas Secretary of State
- (a) Reporting responsibilities. The reporting form must be completed and forwarded to the Texas State Board of Podiatric Medical Examiners for each defendant podiatric physician against whom a professional liability claim or complaint has been filed. The information is to be reported by insurers or other entities providing medical professional liability insurance for a podiatric physician. If an insurance carrier does not adequately report, reporting shall be the responsibility of the podiatric physician.
- (b) Separate reports required and identifying information. One separate report shall be filed for each defendant insured podiatric physician. When Part II is filed it shall be accompanied by the completed Part I or other identifying information as described in subsection (d)(1) of this section.
- (c) Timeframes and attachments. The information in Part I of the form must be provided within 30 days of receipt of the claim or suit. A copy of the claim letter or petition must be attached. The information in those claims where a court order has been entered, a settlement agreement has been reached, or the complaint has been dropped or dismissed.
(d) Alternate reporting formats. The information may be reported either on the form provided or in any other legible format which contains at least the requested data.
(1) If the reporter elects to use a reporting format other than the board's form for data required in Part II, there must be enough identification data available to enable Board staff to match the closure report to the original file. The data required to accomplish this include:
- (A) name and license number of defendant podiatric physician(s); and
- (B) name of plaintiff.
- (2) A court order or settlement agreement is an acceptable alternative submission for Part II. An order or settlement agreement should contain the necessary information to match the closure information to the original file. If the order or agreement is lacking some of the required data, the additional information may be legible written on the order or agreement.
- (e) Penalty. Failure by a licensed insurer to report under this section shall be referred to the State Board of Insurance. Sanctions under the Insurance Code, Article 1.10, §7, may be imposed for failure to report.
- (f) Definition. For the purposes of this chapter a professional liability claim or complaint shall be defined as a cause of action against a podiatric physician for treatment, or other claimed departure from accepted standards of medical or health care or safety which proximately results in injury to or death of the patient, whether the patient's claim or cause of action sounds in tort or contract to include interns, residents, supervising podiatric physicians, on-call podiatric physicians, consulting podiatric physicians, and those podiatric physicians who administer, read, or interpret laboratory tests, x-rays, and other diagnostic studies.
(g) Claims not required to be reported. Examples of claims that are not required to be reported under this chapter but which may be reported include, but are not limited to, the following:
- (1) Product liability claims (i.e. where a podiatric physician invented a medical device which may have injured a patient but the podiatric physician has had no personal podiatric physician-patient relationship with the specific patient claiming injury by the device);
- (2) antitrust allegations;
- (3) allegations involving improper peer review activities;
- (4) civil rights violations; or
- (5) allegations of liability for injuries occurring on a podiatric physician's property, but not involving a breach of duty in the podiatric physician-patient relationship (i.e. slip and fall accidents).
- (6) Business disputes (i.e. podiatric employer-employee dispute, partnership breakups, managed care contract disputes).
- (h) Claims that are not required to be reported under this chapter may however be voluntarily reported pursuant to the provisions of the Podiatric Medical Practice Act of Texas, Texas Occupations Code §202.353.
- (i) The reporting form shall be as follows.
Attached Graphic
Source Note:The provisions of this §130.41 adopted to be effective July 5, 2006, 31 TexReg 5289; transferred effective September 1, 2017, as published in the Texas Register August 18, 2017, 42 TexReg 4145.