Texas Doctors Face Doubt in Bid to Make Insurers Pay ER Bills

Some Texas Supreme Court justices on Tuesday challenged three medical staffing agencies’ argument that a state emergency-care statute creates an implied private right of action when a health-care insurance company fails to pay the “usual and customary rate.”

Texas Medicine Resources LLP, Texas Physician Resources LLP, and Pediatric Emergency Medicine Group LLP alleged that Molina Healthcare of Texas Inc. shorted them on out-of-network emergency medical care by reimbursing less than 15% of the medical service’s list price on average.

Justice Debra Lehrmann asked the providers at oral argument to explain how an emergency care statute implicitly provides a private cause ...