Emergency Care Providers’ Prompt-Pay Penalty Claims Advance

Out-of-network emergency care providers can continue with their claims for payment and penalties under the Texas Prompt Pay Act against an insurer for allegedly failing to cover emergency treatment provided to its insureds (Emerus Hosp. v. Health Care Serv. Corp., 2016 BL 77161, N.D. Ill., 13 C 8906, 3/14/16).

In denying the insurer’s motion to dismiss, Judge Robert W. Gettleman of the U.S. District Court for the Northern District of Illinois held March 14 that the providers may seek penalties under the Texas prompt-pay statute for claims that were deemed nonpayable by the insurer, and thus weren’t ...