On February 3, 2022, the Court of Appeals of Texas, in
PHI Air Medical, LLC v. Texas Mutual Insurance Co., on remand from the state’s supreme court, ruled that the Airline Deregulation Act (ADA) does not preempt the balance billing prohibition in Texas workers compensation (WC) statute 413.042.
In June 2020, the Texas Supreme Court ruled that the ADA did not preempt the state’s “fair and reasonable” WC reimbursement standard for air ambulance billing. On remand, the appellate court considered other issues, including a challenge as to whether the ADA preempts the workers compensation balance billing prohibition, which prohibits medical providers from directly billing WC claimants for any unpaid balance on bill payment received from the employer or WC insurer. The appellate court concluded that balance billing prohibition was not preempted by the ADA. The court also considered other procedural items and concluded that the trial court was required to determine the amount of reimbursement to which the air ambulance carrier was entitled.
This case could be appealed. NCCI will monitor further developments.
For more information on other cases monitored by NCCI’s Legal Division, visit previous Court Case Updates and
Court Case Insights, under the
Legal section of
INSIGHTS on
ncci.com.
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