453-05-5840-m4

DECISION AND ORDER Vista Medical Center Hospital (Provider) requested a hearing on a decision by the Medical Review Division (MRD) of the Texas Department of Insurance, Division of Workers’ Compensation (Division)[1] ordering additional reimbursement to Provider for a hospital stay provided to Claimant, an injured worker. Provider argued that reimbursement for this admission should be […]

453-05-5853-m4

DECISION AND ORDER Vista Medical Center Hospital (Provider) requested a hearing on a decision by the Medical Review Division (MRD) of the Texas Department of Insurance, Division of Workers’ Compensation (Division),[1] denying additional reimbursement to Provider for a hospital stay provided to Claimant, an injured worker. Provider argued that reimbursement for this admission should be […]

453-05-6484-m4

DECISION AND ORDER Liberty Insurance Corporation (Carrier) requested a hearing on a decision by the Medical Review Division (MRD) of the Texas Department of Insurance, Division of Workers’ Compensation (Division)[1] ordering additional reimbursement to Houston Community Hospital (Provider) for a hospital stay provided to Claimant, an injured worker. Provider argued that reimbursement for this admission […]

453-05-6754-m4

DECISION AND ORDER Texas Mutual Insurance Company (Carrier) requested a hearing on a decision by the Medical Review Division (MRD) of the Texas Department of Insurance, Division of Workers’ Compensation (Division)[1] ordering additional reimbursement to Tenet Healthcare/Trinity Medical Center (Provider) for a hospital stay provided to Claimant, an injured worker. Provider argued that reimbursement for […]

453-05-5568-m4

DECISION AND ORDER Vista Hospital of Dallas (Provider) requested a hearing on a decision by the Medical Review Division (MRD) of the Texas Department of Insurance, Division of Workers’ Compensation (Division),[1] denying additional reimbursement to Provider for a hospital stay provided to Claimant, an injured worker. Provider argued that reimbursement for this admission should be […]

453-05-6385-m4

DECISION AND ORDER Vista Medical Center Hospital (Provider) requested a hearing on a decision by the Medical Review Division (MRD) of the Texas Department of Insurance, Division of Workers’ Compensation (Division),[1] denying additional reimbursement to Provider for a hospital stay provided to Claimant, an injured worker. Provider argued that reimbursement for this admission should be […]

454-07-3261-p1

DECISION AND ORDER Service Lloyds Insurance Company (Carrier) challenges a medical interlocutory order (MIO) issued by the Texas Department of Insurance, Division of Workers’ Compensation (Division), requiring it to pay for certain office visits and medications provided over a ninety-day period to an injured worker (Claimant). The Administrative Law Judge (ALJ) finds that Carrier did […]

453-05-5550-m4

DECISION AND ORDER Vista Medical Center Hospital (Provider) requested a hearing on a decision by the Medical Review Division (MRD) of the Texas Department of Insurance, Division of Workers’ Compensation (Division),[1] denying additional reimbursement to Provider for a hospital stay provided to Claimant, an injured worker. Provider argued that reimbursement for this admission should be […]

454-07-0976-p1

DECISION AND ORDER I. INTRODUCTION Sentry Insurance, A Mutual Company (Carrier) challenges a medical interlocutory order (MIO) issued by the Texas Department of Insurance’s Division of Workers’ Compensation (DWC) requiring Carrier to reimburse Alvaro Garcia, M.D., for providing medical services to _______. (Claimant). William Wayne Hairston, D. O., performed a prospective review medical examination (PRME) […]

453-05-5308-m4

DECISION AND ORDER Vista Medical Center Hospital (Provider) requested a hearing on a decision by the Medical Review Division (MRD) of the Texas Department of Insurance, Division of Workers’ Compensation (Division)[1] denying additional reimbursement to Provider for a hospital stay provided to Claimant, an injured worker. Provider argued that reimbursement for this admission should be […]