Judge's Ruling in Stop-Loss Case May Increase Hospital Costs

In a decision that could increase Texas workers' comp costs by hundreds of millions of dollars, a state district judge has held that a "one-prong" test should be applied to determine when to apply a stop-loss provision under the Texas Division of Workers' Compensation's hospital fee guidelines. Travis County Judge Margaret Cooper issued an oral ruling Tuesday in a lawsuit by Vista Community Medical Center against Texas Mutual Insurance Co. A brief filed on behalf of Texas Mutual argues that hospitals "have been raising charges dramatically since the 1997 fee guideline was adopted" and th...