News and Results : SKV Prevails in Texas Supreme Court in Major Insurance Dispute News and Results : SKV Prevails in Texas Supreme Court in Major Insurance Dispute

SKV Prevails in Texas Supreme Court in Major Insurance Dispute

SKV Prevails in Texas Supreme Court in Major Insurance Dispute

On August 30, 2019, the Texas Supreme Court summarily denied United Healthcare’s petition for review of a unanimous appellate court ruling in favor of SKV’s clients regarding an alleged multimillion-dollar healthcare billing dispute. Ultimately, SKV prevailed before the trial court, the appellate court, and the Texas Supreme Court.

In a lawsuit filed in 2015, United claimed fraud by a Houston-area hospital, various emergency centers, and other parties, including SKV’s clients, seeking more than fourteen million dollars in recovery. United alleged that the hospital had improperly billed it for facility fees incurred by the emergency centers under what United called a “sham” affiliation between the hospital and the emergency centers, even though the Centers for Medicare and Medicaid Services had found the hospital and emergency centers were legitimately affiliated and there was no question that the hospital had billed United for facility fees the emergency centers had actually incurred in caring for patients. Moreover, the evidence showed that United’s suit was time-barred because United knew all of the facts that formed the basis of its lawsuit more than four years before the suit.

Before the trial court, the defendants jointly moved for summary judgment on multiple grounds, including federal preemption and the statute of limitations. SKV Partner Jarod Stewart briefed and argued a motion for summary judgment on limitations grounds, which the trial court granted in October 2016. Following appellate briefing and oral argument by SKV Counsel Michelle Stratton, with invaluable contributions by Stewart and a team of co-counsel, the First Court of Appeals unanimously affirmed the trial court’s take-nothing judgment on limitations grounds. The November 29, 2018 published opinion written by Justice Brown, and joined by Chief Justice Radack and Justice Massengale can be found here. United then sought review of the appeals court’s decision, which was summarily denied by the Texas Supreme Court.

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