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Texas Medicine Resources LLP v. Molina Healthcare of Texas, Inc.

Court: Tx Sup  01/13/2023  Supreme Court of Texas Holds No Private Right of Action Against Medical Insurers For Claims Accruing Before 2020

The Supreme Court of Texas held that when the legislature amended the insurance code to provide a mandatory arbitration process for payment disputes between health insurers and emergency room physicians for claims accruing after January 1, 2020, it did not implicitly authorize a private right of action under the insurance code for claims accruing prior to that date and further any claims by the physicians for payment in quantum meruit or unfair settlement practices fail as a matter of law.

health insurance, Emergency Care Statutes, usual and customary rate, Section 1271.155(a), Out-of-Network Claim Dispute Resolution, quantum meruit, remedies not exclusive, private cause of action, necessary implication, assignment

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