United Healthcare of Texas, Inc. Optum Health Care Solutions, LLC D/B/A Optum Healthcare Solutions, Inc. United Healthcare, Inc. D/B/A United Healthcare Insurance Company United Healthcare Community Plan of Texas, L.L.C. Evercare of Texas, L.L.C. United Healthcare Benefits of Texas, Inc. United Healthcare Services, Inc. And UnitedHealth Group, Inc. v. Low-T Physicians Service, P.L.L.C. Low-T Physicians Professional Association And Low-T Physicians Group, P.L.L.C. ( 2021 )

In the
Court of Appeals
Second Appellate District of Texas
at Fort Worth
No. 02-20-00033-CV
UNITED HEALTHCARE OF TEXAS, § On Appeal from the 342nd District Court
INC.; OPTUM HEALTH CARE
SOLUTIONS, LLC D/B/A OPTUM
HEALTHCARE SOLUTIONS, INC.;
UNITED HEALTHCARE, INC. D/B/A
UNITED HEALTHCARE INSURANCE
COMPANY; UNITED HEALTHCARE
COMMUNITY PLAN OF TEXAS, L.L.C.; § of Tarrant County (342-303717-18)
EVERCARE OF TEXAS, L.L.C.; UNITED
HEALTHCARE BENEFITS OF TEXAS,
INC.; UNITED HEALTHCARE SERVICES,
INC.; AND UNITEDHEALTH GROUP,
INC., Appellants
§ January 21, 2021
V.
LOW-T PHYSICIANS SERVICE, P.L.L.C.;
LOW-T PHYSICIANS PROFESSIONAL
ASSOCIATION; AND LOW-T
PHYSICIANS GROUP, P.L.L.C.,
Appellees § Memorandum Opinion by Justice Wallach
JUDGMENT
This court has considered the record on appeal in this case and holds that there
was error in part of the trial court’s order. It is ordered that the order of the trial court
is affirmed in part and reversed in part.
We affirm that portion of the trial court’s order denying arbitration on
Appellants United Healthcare of Texas, Inc.; Optum Health Care Solutions, LLC
d/b/a Optum Healthcare Solutions, Inc.; United Healthcare, Inc. d/b/a United
Healthcare Insurance Company; United Healthcare Community Plan of Texas, L.L.C.;
Evercare of Texas, L.L.C.; United Healthcare Benefits of Texas, Inc.; United
Healthcare Services, Inc.; and UnitedHealth Group, Inc.’s claims for alleged
overpayment (Paragraphs 11, 17, and 18 of Appellants’ Second Amended Answer and
Amended Counterclaim); Appellees Low-T Physicians Service, P.L.L.C.; Low-T
Physicians Professional Association; and Low-T Physicians Group, P.L.L.C.’s claim of
settlement of the overpayment (Count One of Appellees’ Original Petition); and
related claims for costs and attorney’s fees.
We reverse that portion of the trial court’s order denying arbitration on all
parties’ other general claims for declaratory relief of the parties’ rights and obligations
under the provider agreements and applicable state law, and related attorney’s fees and
costs (Counts Two and Three of Appellees’ Original Petition and paragraphs 17-19 of
Appellants’ Second Amended Answer and Counterclaim). We remand this case to the
trial court (1) to refer these general claims for declaratory relief to arbitration pursuant
to the terms of each provider agreement and (2) to address whether to stay claims not
subject to arbitration pending the arbitration.
It is further ordered that Appellants United Healthcare of Texas, Inc.; Optum
Health Care Solutions, LLC d/b/a Optum Healthcare Solutions, Inc.; United
Healthcare, Inc. d/b/a United Healthcare Insurance Company; United Healthcare
Community Plan of Texas, L.L.C.; Evercare of Texas, L.L.C.; United Healthcare
Benefits of Texas, Inc.; United Healthcare Services, Inc.; and UnitedHealth Group,
Inc. shall pay one-half of all costs of this appeal and that Appellees Low-T Physicians
Service, P.L.L.C.; Low-T Physicians Professional Association; and Low-T Physicians
Group, P.L.L.C. shall pay one-half of all costs of this appeal, for which let execution
issue.
SECOND DISTRICT COURT OF APPEALS
By _/s/ Mike Wallach___________________
Justice Mike Wallach