Court Upholds Payment to Treatment Providers Based on Medicare Rate

A Texas appellate court upheld an administrative resolution of a dispute over payment of workers’ compensation medical benefits, finding a group of providers were entitled to reimbursement at 200% of the Medicare rate. Case: Facility Insurance Co. v. Vista Hospital of Dallas, No. 03-18-00663-CV, 12/05/2019, published. Facts and procedural history: Vista Hospital of Dallas, Vista Medical Center Hospital and Surgery Specialty Hospitals of America provided outpatient medical services to injured workers from 2002 to 2008. In 53 instances, the hospitals billed insurance carriers ...