This is an informational bulletin to apprise you of statutory amendments and rules affecting medical professional liability claim reporting to the Texas State Board of Medical Examiners (TSBME).
In 2003, the 78th Regular Session of the Legislature enacted Senate Bill 104 relating to the regulation and enforcement of the practice of medicine by the TSBME. The Occupations Code, §§160.052(a) and 160.053, relating to claim reporting requirements, was amended in Sections 23 and 24 of the bill. The amendments provide that it is no longer necessary to report notice of claim letters. However, insurers and others must still report the payment of any claim, the filing of a lawsuit, and the settlement of a lawsuit, if it is made on behalf of the insured and involves damages relating to the insured's providing medical or health care service. The report must now contain a copy of any expert report filed under Section 13.01, Medical Liability and Insurance Improvement Act of Texas (Article 4590i, Vernon's Texas Civil Statutes) before September 1, 2003, and under Section 74.351, Texas Civil Practice and Remedies Code on and after September 1, 2003. (The expert report requirement under Section 13.01 has been codified with substantive changes in Section 74.351, Texas Civil Practice and Remedies Code, enacted by the 78th Regular Session of the Legislature in House Bill 4).
Rules implementing Subchapter B, Chapter 160, Occupations Code, including the SB 104 amendments, were adopted as 22 TAC §§176.1 - 176.9 by the TSBME, effective January 8, 2004. Insurers must comply with these rules, as applicable, and use the reporting form set forth in §176.9.
You may access the text of the amendments at http://www.capitol.state.tx.us/ by using the "Quick Bill Status" function to retrieve Senate Bill 104. You may access the new TSBME rules at http://www.tmb.state.tx.us/rules/rules/176.php.
Insurers or other entities covering physicians' medical liability insurance should review their claim reporting practices to ensure compliance with these amendments. Chapter 160, Occupations Code, provides that the Commissioner of Insurance may impose sanctions authorized by Chapter 82, Insurance Code, on an insurer who fails to report information to TSBME as required. Please evaluate and adjust your procedures to provide for reporting this information to the Texas Board of Medical Examiners.
For additional information on this bulletin, you may contact Kenneth P. McDaniel, Texas Department of Insurance, 512-305-6711, Ken.McDaniel@tdi.state.tx.us, or Robert Simpson, TSBME, 512-305-7098, Robert.Simpson@tsbme.state.tx.us.
Marilyn Hamilton, Associate Commissioner
Property & Casualty Program MC 104-PC