Court of Appeals of Texas, Twelfth District, Tyler
from the 217th District Court of Angelina County, Texas
(Tr.Ct. No. CV-00624-15-10)
consisted of Worthen, C.J., Hoyle, J., and Neeley, J.
T. Worthen, Chief Justice
Wright, city manager for the City of Lufkin, and Belinda
Melancon Southern, director of finance for the City of
Lufkin, in their official capacities, appeal the trial
court's order granting summary judgment for Johnna
Hooker, Mary Sanford, Brandy Mireles, and Ryan Brewer.
Appellants raise five issues on appeal. We reverse and remand
in part, and reverse and render in part.
were individually involved in separate motor vehicle
accidents alleged to have been caused by the negligence of a
third party. Each Appellee was transported to the hospital
and treated by the City of Lufkin emergency medical services
(EMS) following the accidents. Thereafter, EMS filed medical
services liens, pursuant to Chapter 55 of the property code,
against each Appellee's causes of action resulting from
their respective motor vehicle accidents.
later sued Appellants, seeking a declaratory judgment that
EMS did not timely bill Appellees' respective health
insurance policies and was therefore limited in its recovery
to the amount Appellees would have owed had EMS timely billed
Appellees' health insurance carriers pursuant to Chapter
146 of the Texas Civil Practice and Remedies Code. Appellees
also sought a declaratory judgment that EMS's liens were
invalid under section 55.004(g)(3) of the property code.
Appellees sought an injunction requiring EMS to withdraw the
liens, cease collection efforts, and cease filing liens in
violation of Chapter 146 of the Texas Civil Practice and
Remedies Code and Chapter 55 of the Texas Property Code.
as director of finance, handles the billing for EMS. She
testified at a deposition regarding EMS's billing
practices. She explained that when EMS transports a patient
who was injured in a motor vehicle accident, the billing
personnel (biller) obtains an accident report from the police
department to determine the at fault party's motor
vehicle insurance information. The biller then contacts the
motor vehicle insurance company to determine if an injury
claim has been filed on the policy. If an injury claim has
been filed, the biller submits EMS's bill to the at fault
party's motor vehicle insurance carrier for payment. If a
claim is not filed within several days of the accident, the
biller submits the charges to the patient's health
insurance carrier, if the patient has an active health
testified that when an injury claim is filed and the bill is
submitted to the motor vehicle insurer, the biller monitors
the account and maintains contact with the insurance adjuster
until the claim is paid. If, during pendency of the claim,
the biller believes the injury claim will be unsuccessful,
the biller withdraws the bill from the motor vehicle insurer
and submits the bill to the patient's health insurance
provider. If the patient hires an attorney to pursue a motor
vehicle accident claim, EMS typically files a lien against
the patient's cause(s) of action.
explained that EMS has a contract with Medicare and Medicaid,
but not with any private health insurance carriers. Because
EMS does not contract with private health insurance carriers,
if EMS submits the bill to a private health insurance
carrier, it does not know prior to receiving the
carrier's response if or what percentage of the total
charges the carrier will pay. If EMS submits a bill to a
private health insurer or a motor vehicle insurer and
receives partial payment, EMS bills the patient for any
remaining balance. Southern testified that EMS did not bill
any of the Appellees' health insurance policies, and that
EMS filed a release of Sanford's lien.
the pendency of the litigation, Appellees filed a traditional
motion for summary judgment. Appellants filed a written
response asking the trial court to deny Appellees'
motion, and requesting the court grant summary judgment in
their favor. The trial court granted summary judgment
in favor of Appellees and entered a judgment finding that
Appellants violated Chapter 55 of the property code by filing
liens against Appellees' causes of action "even
though Defendants were entitled to bill Plaintiffs'
medical insurance." The judgment further enjoined
Appellants from continuing the practice of filing EMS liens
against patients who have "coverage under a private
medical indemnity plan or program from which Lufkin EMS is
entitled to recover payment for services under an assignment
of benefits or similar right." This appeal followed.
present four issues challenging the trial court's summary
judgment rulings.They contend that: (1) the trial court
erred in its interpretation of section 55.004(g)(3) of the
property code because EMS has no recourse against a health
insurance provider with which it does not have a contract;
(2) Appellees' did not demonstrate that they had coverage
under a private medical indemnity plan to which EMS had been
given an assignment of benefits or other similar right; (3)
Hooker did not execute an assignment of benefits; and (4)
Sanford's claims are moot because EMS released her lien
prior to filing suit. Appellants urge this Court to reverse
the trial court's judgment and enter a take nothing
judgment in Appellants' favor.
in turn, argue that the trial court correctly granted their
summary judgment motion because section 55.004(g)(3) should
be interpreted to mean that EMS is not entitled to file liens
for services if EMS has a right to be paid by a patient's
private insurance carrier. They further argue that EMS's
lien as to Hooker's causes of action is invalid because
it "filed a lien for $1, 202.00 against Ms. Hooker
despite the statute explicitly limited the maximum charge
covered under the lien to $1, 000." Appellees urge this
Court to affirm the trial court's order granting summary
judgments rendered by summary judgment are reviewed under the
same standards that govern summary judgments generally.
Drake Interiors, L.L.C. v. Thomas, 433 S.W.3d 841,
846 (Tex. App.-Houston [14th Dist.] 2014, pet. denied). We
review a summary judgment de novo. Id.; see also
Valence Operating Co. v. Dorsett, 164 S.W.3d 656, 661
(Tex. 2005). We take as true all evidence favorable to the
non-movant, and indulge every reasonable inference in the
non-movant's favor. Joe v. Two Thirty Nine Joint
Venture, 145 S.W.3d 150, 157 (Tex. 2004); Grynberg
v. Grey Wolf Drilling Co., L.P., 296 S.W.3d 132, 135
(Tex. App.- Houston [14th Dist.] 2009, no pet.).
judgment for a defendant is appropriate only when he negates
at least one element of each plaintiff's theories of
recovery, or pleads and conclusively proves each element of
an affirmative defense. Sci. Spectrum, Inc. v.
Martinez, 941 S.W.2d 910, 911 (Tex. 1997). Evidence is
conclusive only if reasonable people could not differ in
their conclusions. City of Keller v. Wilson, 168
S.W.3d 802, 816 (Tex. 2005). When, as here, both sides move
for summary judgment, each bears the burden of establishing
that it is entitled to judgment as a matter of law ...