12/3/18 - News
Appeals Court Upholds Victory over United Healthcare
In another victory for the firm’s client First Street Hospital LP, the Court of Appeals for the First District of Texas upheld a lower court ruling that United Healthcare Services, Inc. was time-barred from recovering millions of dollars it paid the hospital.
Andy Hicks, lead counsel for First Street, applauded the ruling, saying “First Street Hospital complied fully with all applicable regulations, and United’s claims were and are entirely without merit.”
United, the world’s largest insurer, accused First Street Hospital and the hospital’s freestanding emergency departments of improperly billing the insurer, despite Centers for Medicare and Medicaid Services (CMS) having previously ratified the provider-based relationship at issue in this billing dispute. Through its suit, United sought a refund of approximately $15 million in fees United alleged it had paid First Street for healthcare services provided to United’s insureds.
At the trial court level, SHJ obtained summary judgment for its client on multiple legal bases, including federal preemption under Buckman Co. v. Plaintiffs Legal Committee, also known as the Buckman preemption, and the applicable statute of limitations. Affirming the trial court, Houston’s First Court of Appeals confirmed the validity of First Street’s defenses.
Partners and Logan Johnson, along with Senior Counsel Persis Dean, represented First Street at the trial court level. Appellate Partner, Penny Nicholson, briefed the matter for SHJ’s clients.