Section 180.68 - Medical Quality Review Process(a) The medical quality review process is medical case review initiated on the basis of complaints, plan-based audits, or monitoring as a result of a consent order and performed in accordance with criteria adopted under Labor Code § 413.05115. The medical quality review process does not include medical case review performed for the purpose of:(1) certification and renewal of designated doctors;(2) performance-based oversight;(3) administrative violations that do not require an expert medical opinion; or(4) complaints about professionalism that do not require an expert medical opinion.(b) A complaint must be documented in accordance with the provisions of § 180.2 of this title (relating to Filing a Complaint).(c) Nothing in this subchapter prevents referrals of complaints to another licensing or law enforcement authority.28 Tex. Admin. Code § 180.68
The provisions of this §180.68 adopted to be effective January 1, 2013, 37 TexReg 8839; Amended by Texas Register, Volume 48, Number 33, August 18, 2023, TexReg 4485, eff. 8/22/2023