Molina Beats Out-of-Network Hospitals’ Suit for Higher Payments

Molina Healthcare of Texas Inc. defeated a lawsuit over its alleged underpayment of out-of-network hospitals, as a Texas insurance prompt payment law doesn’t give hospitals a right to sue, a state appeals court said.

The Texas Insurance Code and its implementing regulations lack language indicating that lawmakers intended to authorize health-care providers to sue insurers for noncompliance with statutory payment obligations, the Texas Court of Appeals, Fifth District, said.

Dallas Medical Center LLC, Prime HealthCare Services–Mesquite LLC, and Knapp Medical Center aren’t part of Molina’s provider network. They nevertheless provided emergency care and other services to people who have health ...