A Texas jury ruled in favor of emergency room physicians over Molina Healthcare after a battle over unpaid emergency room wages.
The jury agreed on all counts that Molina Healthcare "engaged in unfair and deceptive practices" after the insurer allegedly refused to fully pay emergency room physicians. The jury's ruling establishes that Molina's alleged unwillingness to pay for emergency room claims provides physicians the ground to sue them directly instead of suing patients.
In a press release, TeamHealth President and CEO Leif Murphy said Molina Healthcare primarily undercut physicians through underpaid reimbursement. Those practices also directly hurt patients, he said.
A Molina spokesperson said the insurer's payment was status quo.
"Molina works hard to provide its low-income members with access to reliable and affordable healthcare. As part of that mission, Molina diligently recruits emergency room doctors to join its network. When a Molina member is treated by an out-of-network doctor, Molina pays that doctor a fair, usual, and customary rate for those services. In this case, Molina believes that the rate it paid to the plaintiff’s doctors was usual and customary, and it is clear that the jury has rejected the plaintiff's exorbitant demands."
The ruling requires Molina to pay $17.5 million in damages.