This declaratory-judgment case has been called the "'lead' stop-loss case" by the agency. The appeal concerns how to construe the stop-loss threshold used in the Texas Workers Compensation system from 1997 to 2008 -- is it a $40,000 bright-line stop-loss threshold, or does the rule contemplate that carriers and hospitals will have to fight over the reasonableness of each claim above that amount?
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Administrative Law Updates, Health Law Updates, Worker’s Compensation Updates
Appellate Brief |
State, 5th Circuit, Texas |
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