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Cmty. Health Choice v. ACS Primary Care Physicians Sw., P.A.

Court of Appeals of Texas, Fourteenth District
Aug 15, 2023
676 S.W.3d 150 (Tex. App. 2023)

Opinion

NO. 14-21-00519-CV

08-15-2023

COMMUNITY HEALTH CHOICE, INC. and Community Health Choice Texas, Inc., Appellants v. ACS PRIMARY CARE PHYSICIANS SOUTHWEST, P.A., Appellee

John Zavitsanos, Sammy Ford IV, Michael Killingsworth, Houston, for Appellee. Courtney B. Glaser, Kelsey Hope, Cameron P. Pope, John B. Shely, Houston, for Appellants.


John Zavitsanos, Sammy Ford IV, Michael Killingsworth, Houston, for Appellee.

Courtney B. Glaser, Kelsey Hope, Cameron P. Pope, John B. Shely, Houston, for Appellants.

Panel consists of Justices Bourliot, Hassan, and Wilson

OPINION

Meagan Hassan, Justice Appellee ACS Primary Care Physicians Southwest, P.A. ("ACS") sued appellants Community Health Choice, Inc. and Community Health Choice Texas, Inc. (together, "Community Health"), for violations of the Texas Insurance Code, quantum meruit, breach of an implied-in-fact contract, and unjust enrichment. Specifically, ACS alleged that Community Health underpaid ACS for medical services provided by its doctors. Community Health filed a plea to the jurisdiction asserting it was immune as to ACS's statutory tort claims. The trial court denied the plea and Community Health filed this interlocutory appeal. See Tex. Civ. Prac. & Rem. Code Ann. §§ 51.014(a)(8), 101.001. For the reasons below, we affirm the denial of Community Health's plea to the jurisdiction.

BACKGROUND

Harris County Hospital District d/b/a Harris Health System ("Harris Health") was created to "furnish medical aid and hospital care to indigent and needy persons residing in the district." See Tex. Health & Safety Code Ann. § 281.002. Harris Health, in turn, created Community Health as a charitable organization to "facilitate the management of a district health care program by providing or arranging health care services, developing resources for health care services, or providing ancillary support services for the district." See id. § 281.0565(b).

Community Health is licensed as a health maintenance organization ("HMO") by the Texas Department of Insurance. In 2014, Community Health entered the Federal Health Insurance Marketplace program and began providing health insurance plans pursuant to the Affordable Care Act. See Tex. Ins. Code Ann. § 1271.004(b) ("[a] health maintenance organization may provide an individual health care plan").

ACS is a Texas corporation that provides physician staffing to hospitals with emergency departments in the greater Houston area. According to ACS, in this role it provides emergency services to all patients regardless of insurance coverage or ability to pay — including patients with health insurance issued or underwritten by Community Health.

ACS sued Community Health in February 2019, alleging that Community Health had underpaid ACS for medical services it rendered to members of Community Health's insurance plans. Contending that Texas law requires HMOs to reimburse health care providers "at the usual and customary rate," ACS alleged that Community Health "reimburs[ed] ACS at amounts far below the usual and customary rate for more than 16,000 individual healthcare claims."

Community Health filed a plea to the jurisdiction challenging all ACS's claims on the basis of lack of standing. The trial court granted the plea as to ACS's claim premised on section 1271.155 of the Texas Insurance Code and denied the plea as to ACS's other claims. See Tex. Ins. Code Ann. § 1271.155(a) (an HMO "shall pay for emergency care performed by non-network physicians or providers at the usual and customary rate or at an agreed rate").

Community Health filed a second plea to the jurisdiction, asserting that immunity barred ACS's claim based on section 541.060 of the Texas Insurance Code. See id. § 541.060 (unfair settlement practices). ACS filed a response and the trial court held a hearing on the plea. On September 10, 2021, the trial court signed an order denying Community Health's second plea. Community Health filed this interlocutory appeal.

ANALYSIS

We begin by addressing our jurisdiction over this appeal.

Although ACS has not challenged Community Health's right to file an interlocutory appeal, we examine our appellate jurisdiction independently and sua sponte. See, e.g., Williams v. Davis , 628 S.W.3d 946, 952 (Tex. App.—Houston [14th Dist.] 2021, no pet.).

I. Appellate Jurisdiction

Our appellate jurisdiction generally is confined to appeals of final judgments. Rusk State Hosp. v. Black , 392 S.W.3d 88, 92 (Tex. 2012). However, the Legislature has specified circumstances in which a litigant may immediately appeal from an order that would otherwise be unappealable because a final judgment has not been rendered in the matter. See Tex. Civ. Prac. & Rem. Code Ann. § 51.014(a) ; see also Cherokee Water Co. v. Ross , 698 S.W.2d 363, 365 (Tex. 1985) (orig. proceeding) (per curiam) ("Unless there is a statute specifically authorizing an interlocutory appeal, the Texas appellate courts have jurisdiction only over final judgments."). Community Health relies on one of these provisions, which permits a litigant to appeal from a trial court's interlocutory order that "grants or denies a plea to the jurisdiction by a governmental unit as that term is defined in [Texas Civil Practice and Remedies Code] Section 101.001." See Tex. Civ. Prac. & Rem. Code Ann. § 51.014(a)(8).

Section 101.001 delineates the types of agencies, subdivisions, and organizations that may be considered a "governmental unit." See id. § 101.001(3) ; see also Rosenberg Dev. Corp. v. Imperial Performing Arts, Inc. , 571 S.W.3d 738, 747-48 (Tex. 2019) (" Rosenberg II ") (describing this definition of "governmental unit" as "broad[ ]"). This definition does not explicitly include a "charitable organization" like Community Health.

But our statutory inquiry does not end there because "[a] charitable organization created by a district under this section is a unit of local government only for purposes of Chapter 101, Civil Practice and Remedies Code." See Tex. Health & Safety Code Ann. § 281.0565(c) (emphasis added). Examining similar statutory language governing economic development corporations, the Texas Supreme Court reasoned:

See Tex. Loc. Gov't Code Ann. § 505.106(b) ("[f]or purposes of Chapter 101, Civil Practice and Remedies Code, a Type B corporation is a governmental unit").

Because the Legislature expressly expanded section 101.001 ’s governmental-unit definition to include economic development corporations, [appellant] is a governmental unit for purposes of the interlocutory appeal authorized by section 51.014(a)(8).

Rosenberg II , 571 S.W.3d at 748.

Guided by this holding, we also conclude that the Legislature expressly expanded section 101.001 ’s governmental-unit definition to include charitable organizations like Community Health. See Tex. Health & Safety Code Ann. § 281.0565(c) ; see also Rosenberg II , 571 S.W.3d at 748. Therefore, Community Health is a governmental unit for purposes of the interlocutory appeal permitted by section 51.014(a)(8), and we may exercise our jurisdiction over this appeal. See Tex. Civ. Prac. & Rem. Code Ann. § 51.014(a)(8) ; see also Rosenberg II , 571 S.W.3d at 748.

II. ACS's Motion to Dismiss

While the appeal was pending, ACS filed a motion to dismiss. Citing a recent decision from the Texas Supreme Court, ACS requested that we dismiss the appeal as moot because it "no longer has a cognizable claim against Community Health under section 541.060." See Tex. Med. Res., LLP v. Molina Healthcare of Tex., Inc. , 659 S.W.3d 424 (Tex. 2023).

In Texas Medical Resources, LLP , emergency-medicine doctors sued an insurer, alleging that the insurer did not pay the doctors at the usual and customary rates for treating its insureds. Id. at 427. In this context, the supreme court examined whether the doctors could bring a claim for unfair settlement practices under chapter 541 of the Texas Insurance Code. See id. at 437-48. The Supreme Court focused on the language in section 541.060(a), which states that "[i]t is an unfair method of competition or an unfair or deceptive act or practice in the business of insurance to engage in the following unfair settlement practices with respect to a claim by an insured or beneficiary ...." Id. at 437 (quoting Tex. Ins. Code Ann. § 541.060(a) ) (emphasis in original). Reasoning that the doctors were "neither insureds nor beneficiaries," the supreme court concluded that the doctors could not pursue their section 541.060 claims for unfair settlement practices. Id. at 438.

Relying on Texas Medical Resources, LLP , ACS asserts that this interlocutory appeal is moot because ACS is not "an insured or beneficiary" as necessary to pursue its section 541.060 claims against Community Health. In response, Community Health asserts that the issues raised in its interlocutory appeal are not moot.

Because we conclude that the requirements necessary to assert a section 541.060 claim fall outside the scope of this interlocutory appeal, we deny ACS's motion to dismiss.

In Texas Medical Resources, LLP , the supreme court noted that the issues it addressed (including its conclusion that section 541.060 claims are limited to "insured or beneficiaries") were each "a pure issue of law pertaining to the merits that should have been raised in the trial court by traditional motion for summary judgment or under Rule 91a — not in a plea to the jurisdiction." Id. at 441. Continuing on, the Court held that "the satisfaction of a statutory or common-law prerequisite to a plaintiff's filing suit or recovering on a claim is not an issue of standing but of merits ." Id. (emphasis added); see also Steel Co. v. Citizens for a Better Env't , 523 U.S. 83, 91, 118 S.Ct. 1003, 140 L.Ed.2d 210 (1998) ("the failure of a cause of action does not automatically produce a failure of jurisdiction"). The court explained that it reached these issues only because "both parties agree that we can render a decision on the merits." Tex. Med. Res., LLP , 659 S.W.3d at 441.

Here, because this is an interlocutory appeal from the denial of Community Health's plea to the jurisdiction, our appellate jurisdiction is limited to issues of subject matter jurisdiction. See, e.g., Houston Indep. Sch. Dist. v. 1615 Corp. , 217 S.W.3d 631, 635 (Tex. App.—Houston [14th Dist.] 2006, pet. denied) (in an appeal from the denial of a plea to the jurisdiction, the court's jurisdiction "is limited to the issues of subject matter jurisdiction"); see also Tex. Civ. Prac. & Rem. Code Ann. § 51.014(a)(8) (permitting an interlocutory appeal from an order that "grants or denies a plea to the jurisdiction by a governmental unit"). The argument asserted in ACS's motion to dismiss — i.e. , that ACS lacks the statutory prerequisites necessary to pursue a section 541.060 a claim — is not relevant to an examination of subject matter jurisdiction. See Tex. Med. Res., LLP , 659 S.W.3d at 441. This argument was not raised in the trial court and, as shown in Community Health's response to ACS's motion to dismiss, it is not one that the parties agree is dispositive. Accordingly, it does not warrant the dismissal of Community Health's interlocutory appeal challenging the trial court's denial of its plea to the jurisdiction.

For these reasons, we deny ACS's motion to dismiss.

III. Governmental Immunity

In its interlocutory appeal, Community Health contends that the trial court erred by denying its second plea to the jurisdiction because it is entitled to governmental immunity.

Although we have determined that Community Health falls within the "broad definition" of governmental unit for purposes of this interlocutory appeal, "it does not necessarily follow that [Community Health] enjoys governmental immunity from suit." Rosenberg Dev. Corp. v. Imperial Performing Arts, Inc. , 526 S.W.3d 693, 701 (Tex. App.—Houston [14th Dist.] 2017), aff'd , 571 S.W.3d 738 (Tex. 2019) ; see also Univ. of the Incarnate Word v. Redus , 518 S.W.3d 905, 911 (Tex. 2017) ("whether an entity is entitled to an interlocutory appeal and whether an entity has sovereign immunity are separate questions with separate analytical frameworks").

A. Standard of Review and General Immunity Principles

We review the trial court's ruling on a plea to the jurisdiction de novo. Tex. Dep't of Parks & Wildlife v. Miranda , 133 S.W.3d 217, 228 (Tex. 2004). A plea to the jurisdiction may challenge either the pleadings or the existence of jurisdictional facts. Id.

When a plea to the jurisdiction challenges the claimant's pleadings, we determine whether the claimant has pleaded facts that affirmatively demonstrate the trial court's jurisdiction, construing the pleadings liberally and in favor of the claimant. Id. ; see also Harris Cnty. Appraisal Dist. v. Braun , 625 S.W.3d 622, 626 (Tex. App.—Houston [14th Dist.] 2021, no pet.). If the moving party challenges the existence of jurisdictional facts, we consider relevant evidence submitted by the parties. Miranda , 133 S.W.3d at 227 ; see also Gillespie v. Galveston Cnty. Health Dist. , 639 S.W.3d 815, 818-19 (Tex. App.—Houston [14th Dist.] 2021, no pet.). If the relevant evidence fails to raise a fact question on the jurisdictional issue, the court rules on the plea as a matter of law. Gillespie , 639 S.W.3d at 819. If the evidence instead creates a fact issue on the jurisdictional issue, the trial court must deny the plea and permit the factfinder to resolve the issue. Id.

Likewise, if resolution of the jurisdictional issue requires interpretation of a statute, we review that statute under a de novo standard. Fort Bend Cnty. Toll Rd. Auth. v. Olivares , 316 S.W.3d 114, 119 (Tex. App.—Houston [14th Dist.] 2010, no pet.). When we construe a statute, our objective is to determine and give effect to the Legislature's intent. Harris Cnty. Hosp. Dist. v. Tomball Reg'l Hosp. , 283 S.W.3d 838, 842 (Tex. 2009). If the statutory language is unambiguous, we adopt the interpretation supported by the words’ plain meaning. Id.

Though often used interchangeably, sovereign immunity and governmental immunity refer to two distinct concepts. Travis Cent. Appraisal Dist. v. Norman , 342 S.W.3d 54, 57-58 (Tex. 2011) ; Hyde v. Harrison Cnty. , 607 S.W.3d 106, 108 n.3 (Tex. App.—Houston [14th Dist.] 2020, pet. denied). Sovereign immunity refers to a state's immunity from suit and liability; this protection extends to the state itself and varying divisions of state government, including agencies, boards, hospitals, and universities. Ben Bolt-Palito Blanco Consol. Indep. Sch. Dist. v. Tex. Pol. Subdivisions Prop./Cas. Joint Self-Ins. Fund , 212 S.W.3d 320, 324 (Tex. 2006). Governmental immunity protects political subdivisions of the state, including counties, cities, and school districts. Wichita Falls State Hosp. v. Taylor , 106 S.W.3d 692, 694 n.3 (Tex. 2003).

Texas jurisprudence also delineates two separate applications of immunity: immunity from suit and immunity from liability. Tooke v. City of Mexia , 197 S.W.3d 325, 332 (Tex. 2006). Immunity from suit bars an action unless the Legislature expressly consents to suit. Tex. Dep't of Transp. v. Jones , 8 S.W.3d 636, 638 (Tex. 1999) (per curiam). If a government defendant is immune from suit, the trial court has no subject matter jurisdiction and the defendant may properly challenge the suit in a plea to the jurisdiction. See Miranda , 133 S.W.3d at 225-26.

In contrast, immunity from liability is a narrower form of protection that guards against a judgment even if the Legislature has expressly consented to the suit. Jones , 8 S.W.3d at 638. Immunity from liability acts as an affirmative defense — it must be pled and does not deprive the trial court of subject matter jurisdiction. Id.

B. Common Law Immunity

On appeal, Community Health asserts that it is entitled to common law immunity.

Because immunity from suit is a common law creation, "[i]t remains the judiciary's responsibility ... to determine under what circumstances sovereign [or governmental] immunity exists in the first instance." Reata Constr. Corp. v. City of Dallas , 197 S.W.3d 371, 375 (Tex. 2006) ; see also Rosenberg Dev. Corp. v. Imperial Performing Arts, Inc. , 526 S.W.3d 693, 701 (Tex. App.—Houston [14th Dist.] 2017) (" Rosenberg I "), aff'd , 571 S.W.3d 738 (Tex. 2019). In undertaking this determination, we are guided by the nature of immunity and the doctrine's purposes. See Univ. of the Incarnate Word v. Redus , 518 S.W.3d 905, 911 (Tex. 2017).

First, as explained by the Texas Supreme Court, "[a]n entity claiming governmental immunity must ordinarily be a political subdivision." Rosenberg II , 571 S.W.3d at 748. Here, Community Health is not a political subdivision — rather, according to its Articles of Incorporation and the amendments thereto, it is a non-profit corporation and a health maintenance and charitable organization organized pursuant to the Texas Health and Safety Code. See Tex. Health & Safety Code Ann. §§ 281.0515, 281.0565. Nothing in the applicable statutes suggests that these types of organizations are intended to operate as political subdivisions. See id. ; see also Ben Bolt-Palito Consol. Indep. Sch. Dist. , 212 S.W.3d at 324-25 (concluding that a self-insurance fund was entitled to governmental immunity, the court noted that the governing statute authorized the fund to include "a combination of political subdivisions"); Rosenberg I , 526 S.W.3d at 705 (concluding that an economic development corporation was not entitled to governmental immunity, this court noted that the authorizing statute explicitly stated that the corporation " ‘is not a political subdivision ... for purposes of the laws of this state’ ") (quoting Tex. Loc. Gov't Code Ann. § 501.055(b) ).

Our second inquiry is more amorphous and examines whether "the governing statutory authority demonstrates legislative intent to grant an entity the ‘nature, purposes, and powers’ of an ‘arm of the State government.’ " Ben Bolt-Palito Blanco Consol. Indep. Sch. Dist. , 212 S.W.3d at 325-26 (quoting Harris Cnty. Flood Control Dist. v. Mann , 135 Tex. 239, 140 S.W.2d 1098, 1101 (1940) ). If this showing is made, the entity "is a government unit unto itself" and is entitled to assert immunity in its own right as to the performance of governmental functions. Id. at 325.

We conclude that Community Health, as a charitable organization created pursuant to section 281.0565 of the Texas Health and Safety Code, is not entitled to governmental immunity from suit. See id. (concluding the self-insurance fund was entitled to governmental immunity because it was performing a "governmental function" that each participating governmental entity was also authorized to perform individually and the "nature, purposes[,] and powers" demonstrated legislative intent that it "exist as a distinct governmental entity entitled to assert immunity in its own right for the performance of a governmental function."); see also Rosenberg II , 571 S.W.3d at 749 ("the Legislature has expressly denied economic development corporations significant governmental characteristics — political-subdivision status and attributes of sovereignty.").

Charitable organizations created under section 281.0565 fall somewhere between the entities examined in Ben Bolt-Palito and Rosenberg II. Significantly, however, charitable organizations are subject to fewer governing statutes. Section 281.0565, entitled "Charitable Organization," states as follows:

(a) In this section, "charitable organization" means an organization that is exempt from federal income tax under Section 501(a) of the Internal Revenue Code of 1986 by being listed as an exempt organization in Section 501(c)(3) or 501(c)(4) of the code.

(b) A district may create a charitable organization to facilitate the management of a district health care program by providing or arranging health care services, developing resources for health care services, or providing ancillary support services for the district.

(c) A charitable organization created by a district under this section is a unit of local government only for purposes of Chapter 101, Civil Practice and Remedies Code.

(d) A district may make a capital or other financial contribution to a charitable organization created by the district to provide regional administration and delivery of health care services to or for the district.

(e) A charitable organization created by a district under this section may contract, collaborate, or enter into a joint venture or other agreement with a public or private entity, without regard to that entity's for-profit or nonprofit status, and may hold an ownership interest in such an entity.

(f) A charitable organization created by a district under this section remains subject to the laws of this state and the United States that govern charitable organizations. Nothing in this section may be construed as abrogating or modifying any other provision of law governing charitable organizations.

Tex. Health & Safety Code Ann. § 281.0565. The parties did not cite — and our research did not find — any other statutory authority governing charitable organizations created in this context. Unlike the statutory scheme examined in Ben Bolt-Palito , section 281.0565 does not explicitly permit charitable organizations to undertake "government functions." Compare Tex. Health & Safety Code Ann. § 281.0565(b) with Tex. Gov't Code Ann. § 791.011(a). Rather, section 281.0565 authorizes charitable organizations to "provid[e] or arrang[e] health care services, develop[ ] resources for health care services, or provid[e] ancillary support services for the district." Tex. Health & Safety Code Ann. § 281.0565(b). These services are not unique to governmental entities. Moreover, Community Health is estopped from making this argument because, as its Articles of Incorporation set out, it operates as a non-profit corporation in addition to its role as a charitable organization.

Further, section 281.0565(e) specifically permits charitable organizations to contract with any other entity, whether private or public, and to hold an ownership interest in those entities. Id. § 281.0565(e). In contrast, the self-insurance fund examined in Ben Bolt-Palito was limited to contracting with other governmental entities. See Tex. Gov't Code Ann. § 791.011.

Although section 281.0565 authorizes charitable organizations like Community Health to provide valuable public health care services, "merely engaging in an act that serves a public purpose says nothing about the nature of the entity itself." Rosenberg II , 571 S.W.3d at 750. Similar to the statutes analyzed in Rosenberg II , the acts authorized by section 281.0565 have "governmental flair" but are not "so uniquely or so definitely [governmental] that only a governmental entity would engage in those activities." Id. This is particularly true in the underlying context, in which ACS alleges that Community Health underpaid ACS for medical services rendered to members of Community Health's insurance plans. The provision of health insurance is not a uniquely governmental function.

See Eliana Lenz, The Pressing Need for Mental Health Parity Law Reform Amid the COVID-19 Pandemic , 31 Annals Health L. Advance Directive 171, 174 (2022) (describing the current health care system and stating that, "[i]n the United States, individuals have different public and private health insurance options"); Lindsay F. Wiley, Privatized Public Health Insurance and the Goals of Progressive Health Reform , 54 U.C. Davis L. Rev. 2149, 2152 (2021) ("most Americans depend on private health insurance").

Finally, the "nature and purposes" underlying the doctrine of immunity do not warrant extending it to charitable organizations created under section 281.0565. See Univ. of the Incarnate Word , 518 S.W.3d at 911. "[T]he doctrine of immunity for governmental entities is inherently connected to the public fisc and preserves separation-of-powers principles by preventing the judiciary from interfering with the Legislature's prerogative to allocate tax dollars." Rosenberg I , 526 S.W.3d at 704. Accordingly, immunity protects the public by preventing disruptions of key government services that may occur when government funds are substantially diverted by litigation. Brown & Gay Eng'g, Inc. v. Olivares , 461 S.W.3d 117, 121 (Tex. 2015).

The parties did not produce any evidence suggesting any key government services are disrupted by funds Community Health will spend on the underlying litigation. Rather, the evidence Community Health submitted to support its plea tends to prove that Community Health is not solely reliant on taxpayer funds for its expenses. As stated in its Articles of Incorporation, Community Health has "the power to solicit grants and contributions for its corporate purposes, and including to have and to exercise all rights and powers conferred on non-profit corporations under the laws of the State of Texas." Therefore, public fisc concerns do not warrant an extension of immunity in these circumstances.

In sum, we conclude that the governing statutory authority does not demonstrate legislative intent to grant Community Health the "nature, purposes, and powers" of an "arm of the State government." See Ben Bolt-Palito Blanco Consol. Indep. Sch. Dist. , 212 S.W.3d at 325-26. Therefore, Community Health is not entitled to the protections afforded by the doctrine of governmental immunity.

C. Statutory Immunity

Relying on Texas Health and Safety Code section 281.0565(c), Community Health asserts that it is entitled to statutory immunity from suit or liability for torts. This subsection states: "A charitable organization created by a district under this section is a unit of local government only for purposes of Chapter 101, Civil Practice and Remedies Code." Tex. Health & Safety Code Ann. § 281.0565(c). "Chapter 101, Civil Practice and Remedies Code" refers to the Texas Tort Claims Act (the "TTCA"). See Tex. Civ. Prac. & Rem. Code Ann. §§ 101.001 - 101.109 ; see also id. § 101.002 ("This chapter may be cited as the Texas Tort Claims Act.").

Reading these statutes together, Community Health asserts that it is a "unit of local government" under the TTCA and that it is therefore entitled to governmental immunity. Contending that ACS's insurance-code claim is a tort claim that does not fall within the TTCA's limited waiver of immunity, Community Health argues that its plea to the jurisdiction should have been granted.

We reject this argument for two reasons.

First, its foundation is shaky — the Texas Supreme Court has not definitely answered the question of "whether the Legislature can confer immunity by statute or only waive it." See Fort Worth Transp. Auth. v. Rodriguez , 547 S.W.3d 830, 842 n.2 (Tex. 2018) ("[w]e do not answer the broader question of whether the Legislature has authority to confer (as opposed to waive) immunity"); Brown & Gay Eng'g, Inc. , 461 S.W.3d at 122 (stating that "[s]overeign immunity is a common-law creation" and its boundaries are delineated by the judiciary; "[b]y contrast ... the Legislature determines when and to what extent to waive immunity"); LTTS Charter Sch., Inc. v. C2 Constr., Inc. , 342 S.W.3d 73, 78 n.44 (Tex. 2011) ("we reserve judgment on ... whether the Legislature in fact has the authority to confer (as opposed to waive) immunity, a common-law creature traditionally delimited by the judiciary").

Second, considering similar statutory language, the Texas Supreme Court declined to find that inclusion in the TTCA's definition of "governmental unit" imbued an entity with governmental immunity. See Rosenberg II , 571 S.W.3d at 747.

Raising a similar argument, the economic development corporation in Rosenberg II relied on the following statutory language to support its contention that it was entitled to governmental immunity: "For purposes of Chapter 101, Civil Practice and Remedies Code, a Type B corporation is a governmental unit and the corporation's actions are governmental functions." Id. (citing Tex. Loc. Gov't Code Ann. § 505.106(b) ). Rejecting this argument, the court reasoned:

We also do not consider the existence vel non of [appellant's] statutory immunity under the Development Corporation Act because section 505.106 does not purport to grant immunity. ... [S]ubsection (b) merely imports the Texas Tort Claims Act's limitations on liability

and damages. As we have observed, "the Tort Claims Act does not create sovereign immunity[;] it provides a limited waiver of that immunity," such that an entity may be sued and damages had on the terms specified in the Tort Claims Act. Because section 505.106 merely purports to limit the remedies available when economic development corporations perform governmental functions, we need not consider whether the Legislature can confer immunity by statute or only waive it.

Id. (quoting Brown & Gay Eng'g, Inc. , 461 S.W.3d at 123 n.6 ).

Therefore, we reject Community Health's contention that its designation as a "governmental unit" under the TTCA renders it entitled to the protections afforded by governmental immunity. See id. ; see also Fort Worth Transp. Auth. , 547 S.W.3d at 842 n.2 ; Brown & Gay Eng'g, Inc. , 461 S.W.3d at 122 ; LTTS Charter Sch., Inc. , 342 S.W.3d at 78 n.44

CONCLUSION

We affirm the trial court's denial of Community Health's second plea to the jurisdiction.

( Wilson, J., dissenting).

DISSENTING OPINION

Randy Wilson, Justice

I disagree with the majority's conclusion that the appellants do not have governmental immunity as to tort claims. The majority reaches this conclusion in a mere seven paragraphs. The issue, however, is not nearly so simple.

First, the majority merely notes that the Texas Supreme Court has not definitely answered the question of "whether the Legislature can confer immunity by statute or merely waive it." Ante at 161. The converse is also correct: the Texas Supreme Court has not held that the Legislature cannot confer immunity. However, while the Supreme Court has not expressly stated that the Legislature can confer immunity, the high court has held that an entity created by a governmental unit was entitled to governmental immunity by virtue of a statute.

In Gulf Coast Center v. Curry , 658 S.W.3d 281 (Tex. 2022), the Supreme Court recently held that Gulf Coast had governmental immunity from suit for a claim seeking to recover in excess of $100,000 per person in personal injury damages when the plaintiff was struck by a bus driven by a Gulf Coast employee. See id. at 286–89. The Gulf Coast Center court stated that an independent basis for its holding was evidence conclusively proving that Gulf Coast was a community center under Chapter 534 of the Health and Safety Code and therefore a unit of local government ("Unit of Local Government") based on the application of section 534.001(c), under which the Legislature provides that a community center is "a unit of local government, as defined and specified by [the Texas Tort Claims Act]." Tex. Health & Safety Code Ann. § 534.001(c) (West, Westlaw through 2023 C.S.); Gulf Coast Center , 658 S.W.3d at 288–89. The Gulf Coast court did not require proof by the community center that it was a Unit of Local Government under the Texas Tort Claims Act (the "Tort Claims Act"). See Id. In addition, the Supreme Court stated that the community center did not need to prove that it was performing a government function at the time of the allegedly tortious conduct to be entitled to governmental immunity from suit because section 534.001(c) did not require such proof. See id. at 289, n.8. Relying on this statute the high court stated, "Thus, the only relevant inquiry is whether Gulf Coast is a community center; if so, it is a unit of local government under the Tort Claims Act." Id. Of course, as the majority notes, if a legislatively authorized entity that is not a political subdivision claims governmental immunity from suit under the common law, then the entity must show that the allegedly actionable conduct was the performance of a governmental function. See Ben Bolt-Palito Blanco Consol. Indep. Sch. Dist. v. Tex. Pol. Subdivisions Prop./Cas. Joint Self-Ins. Fund , 212 S.W.3d 320, 325–26 (Tex. 2006). However, the Supreme Court held that such proof was unnecessary since Gulf Coast was a Unit of Local Government by virtue of a statute.

In Klein v. Hernandez , the Supreme Court of Texas concluded that a private, supported medical school is entitled to the same immunity as governmental entities, without any requirement that the school prove that it is a governmental entity or that it is entitled to sovereign immunity under the common law, because the Legislature provided in sections 312.006 and 312.007 of the Health and Safety Code that supported medical schools should be treated as if they were state agencies. See Klein v. Hernandez , 315 S.W.3d 1, 4–8 (Tex. 2010) ; see also Ruggeri v. Baylor College of Medicine , No. 01-13-00353-CV, 2014 WL 4345165, at *1–2 (Tex. App.—Houston [1st Dist.] Aug. 2014, no pet.) (following Klein and holding that a private, supported medical school had sovereign immunity from suit because the Legislature provided in sections 312.006 and 312.007 of the Health and Safety Code that supported medical schools should be treated as if they were state agencies, without any requirement that the school prove that it is a governmental entity or that it has sovereign immunity under the common law). In Klein , the court relied upon section 312.007(a) :

A medical and dental unit, supported medical or dental school, or coordinating entity is a state agency, and a director, trustee, officer, intern, resident, fellow, faculty member, or other associated health care professional or employee of a medical and dental unit, supported medical or dental school, or coordinating entity is an employee of a state agency for purposes of Chapter 104, Civil Practice and Remedies Code, and for purposes of determining the liability, if any, of the person for the person's acts or omissions while engaged in the coordinated or cooperative activities of the unit, school, or entity.

Tex. Health & Safety Code § 312.007(a) (emphasis added as in Klein ); Klein , 315 S.W.3d at 4–5. This statute was sufficient for the court to conclude that Baylor College of Medicine "is a state agency" for the purposes of determining its liability, if any, for its acts or omissions while engaged in the coordinated or cooperative activities of the school. Klein , 315 S.W.3d at 5.

Thus, although the Texas Supreme Court may not have explicitly stated that the Legislature has the power to enact a statute granting governmental immunity to an entity that would not otherwise be entitled to governmental immunity under the common law, the high court has interpreted other statutes to do precisely that. See Gulf Coast Center , 658 S.W.3d at 286–89 ; Klein , 315 S.W.3d at 4–8.

The majority's second reason to conclude that Community Health does not have governmental immunity pursuant section 281.0565(c) relies exclusively on Rosenberg . See Rosenberg Development Corporation v. Imperial Performing Arts, Inc. , 571 S.W.3d 738 (Tex. 2019). Again, the issue is much more complex than the majority's simple adherence to Rosenberg. In Rosenberg , the Supreme Court held that economic development corporations created by municipalities under the Texas Development Corporation Act "are not governmental entities in their own right and therefore are not entitled to governmental immunity." Id. at 741 ; see Tex. Loc. Gov't Code Ann. §§ 501.001 – 507.202 (West, Westlaw through 2023 C.S.). Part of that Act, section 505.106(b) provides that "[f]or purposes of Chapter 101, Civil Practice and Remedies Code, a Type B [economic development] corporation is a governmental unit and the corporation's actions are governmental functions." Tex. Loc. Gov't Code Ann. § 505.106(b). In the opinion, the high court said that it did not consider whether the corporation had statutory immunity from suit because section 505.106 does not purport to grant immunity. See Rosenberg Dev. Corp. , 571 S.W.3d at 747. The Rosenberg court asserted, without conducting a statutory analysis, that section 505.106(b) "merely imports the Texas Tort Claims Act's limitations on liability and damages." Rosenberg Dev. Corp. , 571 S.W.3d at 747. The Rosenberg court stated that, "[b]ecause section 505.106 merely purports to limit the remedies available when economic development corporations perform governmental functions, we need not consider whether the Legislature can confer immunity by statute or only waive it." Id.

In Rosenberg the issue before the court was whether, under the doctrine of governmental immunity, the economic development corporation had immunity from suit as to the plaintiff's breach-of-contract claim and declaratory-judgment claim regarding a contract. See id. at 742. At most section 505.106(b) would have conferred immunity from suit only as to tort claims, not as to these breach-of-contract and declaratory-judgment claims. Tex. Loc. Gov't Code Ann. § 505.106(b). Thus, addressing whether section 505.106(b) confers immunity from suit was not necessary to the Rosenberg court's judgment. See Rosenberg Dev. Corp. , 571 S.W.3d at 742–43. "Considering the Development Corporation Act as a whole," the Rosenberg court concluded "that the Legislature did not authorize municipalities to create economic development corporations as distinct governmental entities entitled to assert immunity in their own right." Rosenberg Dev. Corp. , 571 S.W.3d at 751. The high court stated, "[w]e hold only that [the economic development corporation] does not independently possess governmental immunity as an arm of the state." Id. at 752.

Rosenberg did not involve section 281.0565 of the Health and Safety Code, and the Rosenberg court emphasized that under the Development Corporation Act, which was at issue in Rosenberg , "an economic development corporation ‘is not a political subdivision or a political corporation for purposes of the laws of this state,’ " and "the Legislature has forbidden authorizing municipalities from bestowing on the corporation any ‘attributes of sovereignty.’ " Id. at 745 (citing respectively, Tex. Loc. Gov't Code Ann. §§ 501.055(b), 501.010 (West, Westlaw through 2023 C.S.)); see Rosenberg Dev. Corp. , 571 S.W.3d at 741, 748–49. The Rosenberg court stated that the Development Corporation Act was "notably unique" in the "directness" with which the Legislature stated that economic development corporations are not political subdivisions or political corporations and should not be given attributes of sovereignty. See Rosenberg Dev. Corp. , 571 S.W.3d at 750. Section 281.0565 of the Health and Safety Code, at issue in this case, does not contain any provision that is the same or similar to either of these parts of the Development Corporation Act. See Tex. Health & Safety Code Ann. § 281.0565. The Supreme Court's opinion in Rosenberg is not on point and does not require a holding in this case that section 281.0565 does not confer any governmental immunity on a charitable organization created by a hospital district under section 281.0565 ("Charitable Organization"). See CPS Energy v. Electric Reliability Council of Texas , 671 S.W.3d 605, 621–22, 628–29 (Tex. 2023) (holding that ERCOT is entitled to sovereign immunity and distinguishing Rosenberg based on the language in the Development Corporation Act providing that an economic development corporation "is not a political subdivision or a political corporation for purposes of the laws of this state" and barring municipalities from delegating to the corporation any "attributes of sovereignty"); Rosenberg Dev. Corp. , 571 S.W.3d at 744–52.

The majority's two stated reasons that section 281.0565(c) does not confer statutory immunity fail. So how should this Court interpret section 218.0565(c)?

Though I disagree with the majority on the merits, I agree with the majority's conclusion that this appeal has not become moot and the majority's denial of ACS's motion to dismiss.

1. Statutory Text

Section 281.0565 of the Health and Safety Code reads in its entirety as follows:

(a) In this section, "charitable organization" means an organization that is exempt from federal income tax under Section 501(a) of the Internal Revenue Code of 1986 by being listed as an exempt organization in Section 501(c)(3) or 501(c)(4) of the code.

(b) A district may create a charitable organization to facilitate the management of a district health care program by providing or arranging health care services, developing resources for health care services, or providing ancillary support services for the district.

(c) A charitable organization created by a district under this section is a unit of local government only for purposes of Chapter 101, Civil Practice and Remedies Code.

(d) A district may make a capital or other financial contribution to a charitable organization created by the district to provide regional administration and delivery of health care services to or for the district.

(e) A charitable organization created by a district under this section may contract, collaborate, or enter into a joint venture or other agreement with a public or private entity, without regard to that entity's for-profit or nonprofit status, and may hold an ownership interest in such an entity.

(f) A charitable organization created by a district under this section remains subject to the laws of this state and the United States that govern charitable organizations. Nothing in this section may be construed as abrogating or modifying any other provision of law governing charitable organizations.

Tex. Health & Safety Code Ann. § 281.0565 (West, Westlaw through 2023 C.S.) (emphasis added).

This is the current version of section 281.0565 of the Health and Safety Code. The Legislature enacted this version effective June 9, 2015, which appears to be after some of the allegedly actionable conduct but before other allegedly actionable conduct and before ACS filed suit. See Act of May 20, 2015, 84th Leg., R.S., ch. 363, §§ 2,4 2015 Tex. Sess. Law Serv. 1552, 1552–53. I presume that the current version of the statute applies in this case.

2. Statutory Interpretation Rules

We review the trial court's interpretation of applicable statutes de novo. Texas Health Presbyterian Hosp. of Denton v. D.A. , 569 S.W.3d 126, 131 (Tex. 2018). In interpreting a statute, the objective is to determine and give effect to the Legislature's intent. See Pape Partners, Ltd. v. DRR Family Properties LP , 645 S.W.3d 267, 272 (Tex. 2022). We discover that intent within the language the Legislature enacted. Texas Health Presbyterian Hosp. , 569 S.W.3d at 136. When interpreting statutes, we look to the plain meaning of the enacted text. KMS Retail Rowlett, LP v. City of Rowlett , 593 S.W.3d 175, 183 (Tex. 2019). A statute's unambiguous language is the surest guide to the Legislature's intent because the Legislature expresses its intent through the words it enacts and declares to be the law. Texas Health Presbyterian Hosp. , 569 S.W.3d at 136. Courts must enforce a statute as written and refrain from rewriting text that the Legislature chose. Id. We do not use extrinsic aids, such as legislative history, to interpret unambiguous statutory language because the statute's plain language most reliably reveals the Legislature's intent. Id. Rather, we limit our analysis to the words of the statute and apply the plain meaning of those words " ‘unless a different meaning is apparent from the context or the plain meaning leads to absurd or nonsensical results.’ " KMS Retail Rowlett , 593 S.W.3d at 183 (quoting Molinet v. Kimbrell , 356 S.W.3d 407, 411 (Tex. 2011) ). In doing so, we use definitions the Legislature has prescribed and take into account any technical or particular meaning the words have acquired. KMS Retail Rowlett, LP , 593 S.W.3d at 183. While we must consider the specific statutory language at issue, we must do so while looking to the statute as a whole, rather than as " ‘isolated provisions.’ " Id. (quoting TGS–NOPEC Geophysical Co. v. Combs , 340 S.W.3d 432, 439 (Tex. 2011) ). If the statutory language is susceptible to two or more reasonable interpretations, and we cannot discern legislative intent in the language of the statute itself, then the language is ambiguous. Texas Health Presbyterian Hosp. , 569 S.W.3d at 130, n.6.

3. Statutory Interpretation

In the trial court appellee ACS Primary Care Physicians Southwest, P.A. ("ACS") alleges various claims against the Community Health Parties, including a claim under section 541.151 of the Insurance Code for actual damages caused by the Community Health Parties allegedly engaging in one of the unfair settlement practices listed in section 541.060 of the Insurance Code (collectively the "Unfair Settlement Claims"). The Harris County Hospital District d/b/a Harris Health System (the "Hospital District") created appellants Community Health Choice, Inc. and Community Health Choice Texas, Inc. (collectively the "Community Health Parties") as non-profit, tax-exempt, charitable organizations under section 281.0565 of the Health and Safety Code. Under the unambiguous language of section 281.0565, each of the Community Health Parties is a Charitable Organization, and thus each of them is "a unit of local government only for purposes of [the Tort Claims Act]." Tex. Health & Safety Code Ann. § 281.0565(c). See Hall v. Dixon , No. H-09-2611, 2010 WL 3909515, at *31 (S.D. Tex. Sep. 30, 2010), aff'd sub nom. Hall v. Smith , 497 Fed. Appx. 366 (5th Cir. 2012).

This raises the key question in this case: under section 281.0565 what does it mean to be "a unit of local government only for purposes of [the Tort Claims Act]"?

This phrase refers to the entire Tort Claims Act, not to one section or part of the Tort Claims Act, and the phrase uses the plural "purposes." Under the plain text of section 281.0565(c), a Charitable Organization is a Unit of Local Government for all of the purposes of the Tort Claims Act. See Tex. Health & Safety Code Ann. § 281.0565. Section 101.021 of the Tort Claims Act creates liability for a Unit of Local Government for (1) property damage, personal injury, and death proximately caused by the wrongful act or omission or the negligence of an employee acting within his scope of employment if: (A) the property damage, personal injury, or death arises from the operation or use of a motor-driven vehicle or motor-driven equipment; and (B) the employee would be personally liable to the claimant according to Texas law; and (2) personal injury and death so caused by a condition or use of tangible personal or real property if the Unit of Local Government would, were it a private person, be liable to the claimant according to Texas law. See Tex. Civ. Prac. & Rem. Code Ann. § 101.021 (West, Westlaw through 2023 C.S.); Osman v. City of Fort Worth , No. 02-21-00117-CV, 2022 WL 187984, at *8 (Tex. App.—Fort Worth Feb. 17, 2022, pet. denied) (mem. op.). Thus, the Tort Claims Act provides a waiver of a Unit of Local Government's immunity from liability to the extent of the liability created as to these claims against a Unit of Local Government under the Tort Claims Act. See Tex. Civ. Prac. & Rem. Code Ann. § 101.021 ; Gulf Coast Center , 658 S.W.3d at 284 ; Osman , 2022 WL 187984, at *8. The Tort Claims Act limits the liability created for these claims against a Unit of Local Government to money damages in a maximum amount of $100,000 for each person and $300,000 for each single occurrence for bodily injury or death and $100,000 for each single occurrence for injury to or destruction of property. See Tex. Civ. Prac. & Rem. Code Ann. § 101.023 (West, Westlaw through 2023 C.S.). The immunity from suit of a Unit of Local Government under the doctrine of governmental immunity is waived to the extent of liability created by the Tort Claims Act. See Tex. Civ. Prac. & Rem. Code Ann. § 101.025 (West, Westlaw through 2023 C.S.); Gulf Coast Center , 658 S.W.3d at 284 ; Tex. Dep't Parks & Wildlife v. Miranda , 133 S.W.3d 217, 224 (Tex. 2004) ; Osman , 2022 WL 187984, at *8. The Tort Claims Act contains other provisions delineating the scope of the liability created by the statute. See, e.g. , Tex. Civ. Prac. & Rem. Code Ann. § 101.0211 (West, Westlaw through 2023 C.S.) (providing that the common law doctrine of vicarious liability because of participation in a joint enterprise does not impose liability for a claim brought under this chapter on certain entities that are political subdivisions of this state); Tex. Civ. Prac. & Rem. Code Ann. § 101.022 (West, Westlaw through 2023 C.S.) (limiting the duty owed by the governmental unit to the claimant in certain situations as to the premises liability created in section 101.023 ); Tex. Civ. Prac. & Rem. Code Ann. § 101.024 (West, Westlaw through 2023 C.S.) (stating that the Tort Claims Act does not authorize exemplary damages). If a plaintiff asserts one of the claims listed in section 101.021 of the Tort Claims Act against a Unit of Local Government but seeks to recover an amount on that claim in excess of the limits provided in section 101.023, the Unit of Local Government retains immunity from suit as to this claim, and the trial court lacks jurisdiction over the claim. See Tex. Civ. Prac. & Rem. Code Ann. § 101.023 (West, Westlaw through 2023 C.S.); Gulf Coast Center , 658 S.W.3d at 286–87. Considering the Tort Claims Act as a whole and under its unambiguous language, one of the purposes of the Tort Claims Act is to waive the governmental immunity from suit and liability in tort of Units of Local Government by creating liability against Units of Local Government for several tort claims and by waiving these units’ immunity from suit to the extent of this created liability. See Tex. Civ. Prac. & Rem. Code Ann. § 101.001, et seq. ; Gulf Coast Center , 658 S.W.3d at 284-87 ; Miranda , 133 S.W.3d at 224 ; State Dep't of Highways & Public Transp. v. Gonzalez , 82 S.W.3d 322, 326 (Tex. 2002) ; Osman , 2022 WL 187984, at *8.

Section 101.106 of Tort Claims Act is a comprehensive election-of-remedies provision that confers immunity on employees of governmental units under certain circumstances. See Tex. Civ. Prac. & Rem. Code Ann. § 101.106 (West, Westlaw through 2023 C.S.); Franka v. Velasquez , 332 S.W.3d 367, 371 n. 9, 381 (Tex. 2011). Section 101.101 of the Tort Claims Act imposes certain notice requirements on parties asserting claims for which immunity is waived by the statute, and these notice requirements are a condition of the Tort Claims Act's waiver of immunity from suit. See Tex. Civ. Prac. & Rem. Code Ann. § 101.101 (West, Westlaw through 2023 C.S.); Colquitt v. Brazoria County , 324 S.W.3d 539, 542–43 (Tex. 2010).

Hall v. Dixon is the only reported decision addressing whether section 281.0565 imparts governmental immunity to a charitable organization created under that section, and, ironically, that decision involved Community Health Choice, Inc. ("Community Health"), one of the appellants in this case. See Hall , 2010 WL 3909515, at *30–32. In Hall , plaintiff sued multiple defendants following the death of her child. See id. at *1. With respect to Community Health, plaintiff alleged that Community Health refused to pay for a second opinion resulting in a delay of medical care. See id. Plaintiff asserted claims under common-law negligence and statutory negligence under Texas Civil Practice and Remedies Code section 88.002. Id. at *30. Community Health filed a motion to dismiss arguing that it is immune from suit from both the statutory and common-law claims under Health and Safety Code section 281.0565(c). Id. Judge Rosenthal held that under plain language of section 281.0565(c), Community Health should be treated as a Unit of Local Government and that Community Health had governmental immunity as to tort claims for which its immunity had not been waived. Id. at *30–32. In Hall , plaintiff moved for leave of court to add a claim that Community Health violated section 541.060 of the Insurance Code proscribing certain unfair insurance practices, again ironically, the same section that ACS claims that Community Health violated in this case. Id. at *31–32. Judge Rosenthal denied this motion as futile because there had been no waiver of the governmental immunity conferred on Community Health by section 281.0565. Id.

ACS argues that a Unit of Local Government for the purposes of the Tort Claims Act does not have any governmental immunity because the Tort Claims Act does not create governmental immunity. While the Tort Claims Act does not create governmental immunity, which arises under the common law, this fact does not mean that a Unit of Local Government for the purposes of the Tort Claims Act does not have any governmental immunity. If a Unit of Local Government did not have governmental immunity as to tort claims, it would not be a Unit of Local Government for the purposes of the Tort Claims Act because (1) the Tort Claims Act would not be able to create tort liability for the Unit of Local Government, which would exist under the common law absent governmental immunity from tort liability, and (2) there would be no governmental immunity for the Tort Claims Act to waive under section 101.025. See Tex. Civ. Prac. & Rem. Code Ann. § 101.025. Under the unambiguous language of the Tort Claims Act, imposing limitations on liability and damages as to existing tort claims against entities that do not have sovereign or governmental immunity is not a purpose of the Tort Claims Act. See Tex. Civ. Prac. & Rem. Code Ann. § 101.001, et seq. ; Gulf Coast Center , 658 S.W.3d at 284–87. For example, section 101.023 is one of various sections of the Tort Claims Act that describe the tort claims as to which the statute waives the sovereign or governmental immunity of the various governmental units. See Tex. Civ. Prac. & Rem. Code Ann. § 101.023.; Gulf Coast Center , 658 S.W.3d at 284–87. The Tort Claims Act does not waive a Unit of Local Government's immunity from suit or from liability as to a claim listed in section 101.021 in which the claimant seeks to recover an amount in excess of the limits provided in section 101.023. See Tex. Civ. Prac. & Rem. Code Ann. § 101.023 ; Gulf Coast Center , 658 S.W.3d at 285.

Under section 281.0565(c), a Charitable Organization is a Unit of Local Government for all of the purposes of the Tort Claims Act. See Tex. Health & Safety Code Ann. § 281.0565. One of these purposes is to waive the governmental immunity from suit and liability in tort of Units of Local Government by creating liability against such units for several tort claims and by waiving the units’ immunity from suit to the extent of this created liability. See Tex. Civ. Prac. & Rem. Code Ann. § 101.001, et seq. ; Gulf Coast Center , 658 S.W.3d at 284–87. Because of this purpose and because Units of Local Government are generally entitled to governmental immunity, it would not be reasonable to interpret section 281.0565 as not granting a Charitable Organization governmental immunity as to tort claims for which a Unit of Local Government's governmental immunity has not been waived. See Tex. Health & Safety Code Ann. § 281.0565 ; Hall , 2010 WL 3909515, at *30–32. Under the unambiguous language of section 281.0565(c), each of the Community Health Parties is a Unit of Local Government only for purposes of the Tort Claims Act and thus has governmental immunity as to tort claims for which a Unit of Local Government's governmental immunity has not been waived. See Tex. Health & Safety Code Ann. § 281.0565 ; Hall , 2010 WL 3909515, at *30–32 (holding by Judge Rosenthal that under plain language of section 281.0565(c), Community Health Choice, Inc., one of the appellants in today's case, should be treated as a Unit of Local Government and that Community Health Choice, Inc. had governmental immunity as to tort claims for which its immunity had not been waived). Of course, under the plain meaning of the word "only," the Community Health Parties are not a Unit of Local Government for other purposes and thus do not have governmental immunity as to non-tort claims. See Tex. Health & Safety Code Ann. § 281.0565.

ACS asserts that the sections of the Tort Claims Act limiting liability, including section 101.023, are not part of the waiver of sovereign and governmental immunity and that these sections create limitations of liability and damages applicable to any entity covered by the Tort Claims Act, regardless of whether the entity has sovereign or governmental immunity. Gulf Coast Center answers this question too. There, the Supreme Court disagreed with this assertion as to section 101.023, concluding that this section is part of the waiver of sovereign and governmental immunity under Tort Claims Act. Gulf Coast Center , 658 S.W.3d at 285. In addition, under the unambiguous language of the Tort Claims Act, section 101.023 limits the liability created under the statute as to various types of governmental units, all of which are generally entitled to sovereign or governmental immunity. See Tex. Civ. Prac. & Rem. Code Ann. § 101.001, et seq. ; Gulf Coast Center , 658 S.W.3d at 284–87. Though ACS argues that section 101.023 limits the liability of any entity covered by the Tort Claims Act, even if the entity is not generally entitled to sovereign or governmental immunity, ACS cites no authority that supports this proposition. Under the unambiguous language of the Tort Claims Act, section 101.023 limits the liability only of entities generally entitled to sovereign or governmental immunity, as part of the statute's description of the liability created under the Tort Claims Act, as to which immunity from suit is waived under section 101.025. See Tex. Civ. Prac. & Rem. Code Ann. § 101.001, et seq. ; Gulf Coast Center , 658 S.W.3d at 284–87.

The only reasonable interpretation of section 281.0565 ’s text is that a Charitable Organization has governmental immunity as to tort claims for which a Unit of Local Government's governmental immunity has not been waived. See Tex. Health & Safety Code Ann. § 281.0565 ; Hall , 2010 WL 3909515, at *30–32 ; Klein , 315 S.W.3d at 4–8 ; Ruggeri , 2014 WL 4345165, at *1–2. Because section 281.0565 does not require any such showing, the Community Health Parties need not show that (1) they are a Unit of Local Government, (2) they are entitled to immunity under the common law, or (3) they were performing a governmental function when they engaged in the conduct made the basis of the Unfair Settlement Claims. See Tex. Health & Safety Code Ann. § 281.0565 ; Gulf Coast Center , 658 S.W.3d at 289 & n.8. The plain meaning of the statutory language does not lead to absurd or nonsensical results, and a meaning different from this plain meaning is not apparent from the context. In this scenario, our function is not to question the wisdom of the statute or to seek to rewrite it based upon a different view of public policy; rather, absent a constitutional infirmity in section 281.0565, we must give effect to the statute's unambiguous language. See KMS Retail Rowlett , 593 S.W.3d at 183 ; Jones v. Del Andersen & Assocs. , 539 S.W.2d 348, 351 (Tex. 1976) ; Patel v. Harris County Appraisal Dist. , 434 S.W.3d 803, 811 (Tex. App.—Houston [14th Dist.] 2014, no pet.). No party has asserted that section 281.0565 is unconstitutional.

Under the unambiguous language of section 281.0565, the Community Health Parties have governmental immunity as to tort claims for which a Unit of Local Government's governmental immunity has not been waived. Because ACS did not carry its burden of affirmatively demonstrating the trial court's jurisdiction by alleging a valid waiver of the Community Health Parties’ governmental immunity as to the Unfair Settlement Clams, the trial court erred in denying the Community Health Parties’ plea to the jurisdiction. Therefore, this court should sustain the Community Health Parties’ sole issue, reverse the trial court's order denying the plea to the jurisdiction, and render judgment sustaining the jurisdictional plea and dismissing the Unfair Settlement Claims with prejudice based on governmental immunity. Because this court instead affirms the trial court's order, I respectfully dissent.


Summaries of

Cmty. Health Choice v. ACS Primary Care Physicians Sw., P.A.

Court of Appeals of Texas, Fourteenth District
Aug 15, 2023
676 S.W.3d 150 (Tex. App. 2023)
Case details for

Cmty. Health Choice v. ACS Primary Care Physicians Sw., P.A.

Case Details

Full title:COMMUNITY HEALTH CHOICE, INC. AND COMMUNITY HEALTH CHOICE TEXAS, INC.…

Court:Court of Appeals of Texas, Fourteenth District

Date published: Aug 15, 2023

Citations

676 S.W.3d 150 (Tex. App. 2023)

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