Vista Community Health Center v. Texas Mutual Insurance Co.

Amicus Brief (on rehearing)

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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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Published In: Administrative Agency Updates, Health Updates, Worker’s Compensation Updates

Reference Info:Appellate Brief | State, 5th Circuit, Texas | United States

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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