Texas Jury Holds Molina Healthcare Accountable for Refusing to Pay Frontline Emergency Room Doctors

KNOXVILLE, Tenn., June 25, 2021 (GLOBE NEWSWIRE) — Yesterday, a Texas jury ruled that Molina Healthcare “engaged in unfair and deceptive practices” by intentionally failing to pay frontline emergency room doctors for care provided to patients, including during the COVID-19 crisis. The jury found in favor of the physicians on all questions in the case.

“We are pleased that the jury held Molina Healthcare accountable for their abusive reimbursement practices,” said TeamHealth President & CEO Leif Murphy. “The evidence showed that Molina, like many insurance companies across the United States, refused to negotiate fair reimbursement with emergency medicine physicians, coercively underpaid physicians and exposed its members to its underpaid balances. Molina’s practices have directly hurt patients. In the Houston metropolitan area, only two emergency departments are in Molina’s network and many of their members across Texas are hours from the closest in-network emergency physicians.”

The jury found for the physicians on every question including that Molina had “engaged in unfair and deceptive practices” and failed to act in good faith in paying the emergency physicians’ claims. In light of the hundreds of millions of dollars that Molina made annually on its Texas Marketplace product through government subsidy of the premiums Molina collects, the jury awarded the physicians $17.5 million in punitive damages, sending a message to Molina and the insurance industry that such abusive payment practices will not be tolerated.

“Molina has continued to maintain that emergency medicine physicians have no right to sue Molina for underpayment and must sue their patients instead,” Murphy added. “Molina’s practice of putting patients in the middle of an underpayment dispute is exactly why the No Surprises Act was necessary. Molina’s unfair and deceptive practice of underpaying providers and its scant network are evidence of why the No Surprises Act should not rely upon an insurer’s own determination of its median contracted rate to establish payment for out of network emergency services.”

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