March 26, 2020

Texas ER Providers and Insurers Continue to Fight New Surprise Billing Law

Emergency care providers continue to file lawsuits against payors asserting failure to pay usual and customary charges under the Texas Insurance Code. This issue has become more acute in part because of a surprise billing law that went into effect on January 1.  The latest class action filed by freestanding emergency centers is Piney Woods ER III, LLC, et al. v. Blue Cross and Blue Shield of Texas, USDC ED TX, No. 1:20-cv-00112-MJT (March 19, 2020).  Other cases are Angelina Emergency Medicine Associates, P.A., et al. v. Health Care Service Corp., et al., USDC ND TX, No. 3:18-cv-00425-X Texas Med. Res., et al. v. Molina Healthcare of Texas, Inc., No. DC-18-14467, 160th JDC, Dallas, TX (dism. in favor of health plan, on appeal); Dallas Med. Center, LLC v. Molina Healthcare of Texas, Inc., DC-18-06920, 193rd JDC, Dallas, TX (dismissed in favor of health plan, on appeal); Emergency Serv. of Texas, P.A., et al., v. Celtic Ins. Co., et al.  ­D-1-GN-18-003838, 459th JDC, Travis County, TX (dism. in favor of health plan).