Hole torn in a dollar bill with Healthcare text.©zimmytws – stock.adobe.com In Texas Appellate Court, Physicians' Loss on Out-of-Network Rates Erases $5.5M Attorney Fees
The physicians admitted a meeting of the minds is needed to form a binding contract, but claimed a specific dollar amount is not required for a contract to be enforceable.
August 02, 2024 at 01:43 PM
4 minute read
What You Need to Know
- The First Court of Appeals wiped out a $10.2 million final judgment for non-network physicians.
- The decision is in part a consequence of a Texas Supreme Court ruling that non-work providers don't have a private right of action for damages.
A Texas appellate court ruling left open the question of what constitutes "usual and customary rates" for non-network doctors and reversed $4.7 million judgment and a $5.5 million attorney fees award.
Molina Healthcare of Texas Inc., a health maintenance organization, appealed a final judgment from Harris County's 113th District Court that favored two physicians networks—ACS Primary Care Physicians Southwest PC and Emergency Services of Texas PA.
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