Matthew Baumgartner and David King secured a favorable ruling from the Austin Court of Appeals allowing Graves Dougherty’s client, the Texas Association of Health Plans, to bring a legal challenge to Texas Department of Insurance rules concerning health plan liability for medical provider out-of-network billed charges. Unregulated medical provider charges, combined with the practice of balance billing insured patients, presents a real challenge for Texas health insurers and HMOs in their efforts to contain costs and build adequate health care networks. This lawsuit is part of Texas health plans’ continuing efforts to address these problems for the benefit of Texas insureds and the businesses who provide their employees with health plans. TDI had argued it was immune from the lawsuit. The Austin Court of Appeals’ ruling is available here.
Mr. Baumgartner is a shareholder in Graves Dougherty’s appellate and administrative & regulatory litigation teams, and argues health care cases in courts across the country. Mr. King is a shareholder in Graves Dougherty’s civil litigation section and represents a wide array of clients in commercial and regulatory litigation.