Texas Mutual Insurance Company// Eckerd Corporation H.E. Butt Grocery Company Third-Party Solutions, Inc. Wal-Mart Stores, Inc. Apollo Enterprises, Inc. And Walgreen Company v. Eckerd Corporation H.E. Butt Grocery Company Third-Party Solutions, Inc. Wal-Mart Stores, Inc. Apollo Enterprises, Inc. And Walgreen Company//Cross-Appellee,Texas Mutual Insurance Company
This case involves cross-appeals concerning whether an insurance company must first exhaust administrative remedies under the Texas Workers' Compensation Act before filing a lawsuit for alleged overcharges by health care providers. Appellant Texas Mutual Insurance Company sued several pharmacies and billing companies for negligent misrepresentation and money had and received, claiming they over-billed for prescription drugs. The district court denied the defendants' motion to dismiss for lack of subject matter jurisdiction but granted partial summary judgment against Texas Mutual. The Court of Appeals, relying on prior precedent, determined that the Texas Workers' Compensation Commission holds exclusive jurisdiction over medical fee disputes within the Act's pervasive regulatory scheme. Consequently, the appellate court reversed the district court's judgment, concluding that the trial court lacked jurisdiction as Texas Mutual had not exhausted its administrative remedies.