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NORTH CYPRESS MED. CENTER v. AETNA LIFE INS.

No. 16-20674.

898 F.3d 461 (2018)

NORTH CYPRESS MEDICAL CENTER OPERATING COMPANY, LIMITED; North Cypress Medical Center Operating Company GP, L.L.C., Plaintiffs-Appellees Cross-Appellants, v. AETNA LIFE INSURANCE COMPANY, Defendant-Appellant Cross-Appellee.

United States Court of Appeals, Fifth Circuit.

July 31, 2018.

Attorney(s) appearing for the Case

John Douglas Sutter, Esq. , Kelly, Sutter & Kendrick, P.C., Houston, D. Brian Hufford, Esq. , Zuckerman Spaeder, L.L.P., New York, Neil L. Prupis , Wilson, Elser, Moskowitz, Edelman & Dicker, L.L.P., Florham Park, for Plaintiff-Appellee Cross-Appellant.

Miguel Angel Estrada , Matthew Scott Rozen , Geoffrey M. Sigler, Esq. , Gibson, Dunn & Crutcher, L.L.P., Washington, John Bruce Shely, Esq. , Hunton Andrews Kurth, L.L.P., Houston, for Defendant-Appellant Cross-Appellee.

Before SMITH, WIENER, and WILLETT, Circuit Judges.

Under Aetna's insurance plans, patients are responsible for a portion of their bills. That is not to say insurance companies are off the hook: They cover the remainder. But how much is Aetna obligated to pay for medical services provided to its members by an out-of-network hospital?

Houston medical services...

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