Texas Prompt Pay Act Doesn’t Reach Self-Funded Plans

A Texas law setting deadlines for paying health insurance claims doesn’t apply to administrators of self-funded plans, the U.S. Court of Appeals for the Fifth Circuit ruled, dodging the question of whether the Texas Prompt Pay Act is preempted by the federal Employee Retirement Income Security Act (Aetna Life Ins. Co. v. Methodist Hosps. of Dall., 2016 BL 46233, 5th Cir., 15-10210, unpublished 2/18/16).

As a result of this ruling, Aetna Life Insurance Co. won’t have to pay more than $10 million in penalties to a Dallas hospital that accused the insurer of paying claims after the ...