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ACS PRIMARY CARE PHYSICIANS v. UNITEDHEALTHCARE

No. 21-20168.

26 F.4th 716 (2022)

ACS PRIMARY CARE PHYSICIANS SOUTHWEST, P.A.; Hill County Emergency Medical Associates, P.A.; Longhorn Emergency Medical Associates, P.A.; Central Texas Emergency Associates, P.A.; Emergency Associates of Central Texas, P.A.; Emergency Services of Texas, P.A., Plaintiffs-Appellees, v. UNITEDHEALTHCARE INSURANCE COMPANY; UnitedHealthcare of Texas, Incorporated, Defendants-Appellants.

United States Court of Appeals, Fifth Circuit.

FILED February 23, 2022.

Attorney(s) appearing for the Case

Nina Cortell , Alicia Pitts , Haynes & Boone, L.L.P., Dallas, TX, Justin C. Fineberg, Esq. , Lash & Goldberg, L.L.P., Fort Lauderdale, FL, Christopher Knight , Haynes & Boone, L.L.P., Fort Worth, TX, Jane Langdell Robinson , John M. Zavitsanos, Esq. , Ahmad, Zavitsanos, Anaipakos, Alavi & Mensing, P.C., Houston, TX, Jonathan E. Siegelaub , Lash & Goldberg, L.L.P., Weston, FL, Mark R. Trachtenberg , Haynes & Boone, L.L.P., Houston, TX, for Plaintiffs-Appellees.

Andrew George Jubinsky , Donald Colleluori, Esq. , Figari & Davenport, L.L.P., Dallas, TX, Cameron Jean , Crawford, Wishnew & Lang, P.L.L.C., Dallas, TX, for Defendants-Appellants.

Before King, Graves, and Ho, Circuit Judges.

Texas state law requires that health plan administrators pay emergency-care providers their "usual and customary rate" when those providers give emergent care to an out-of-network plan enrollee. Today, we are asked whether that same state law also creates an implied private right of action on behalf of those emergency-care providers...

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