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Click here for the full text of this decision FACTS:HealthSouth Medical Center is a Dallas hospital. Employers Insurance Co. of Wausau is a workers’ compensation insurance carrier. Each party had an independent contract with First Health Group, a healthcare network: HealthSouth is a preferred provider under the network; Wausau is an insurance carrier for the network. HealthSouth and Wausau did not contract directly with each other. HealthSouth’s contract with First Health set contract rates for various services HealthSouth would perform as a preferred provider. The contract also provided in relevant part: “Notwithstanding the Contract rates contained herein, the amount payable under the terms of this Contract shall be the lesser of [a] the Contract rate, [b] a 25% discount from billed charges, or [c] the amount payable under guidelines established under any State law or regulation pertaining to health care services rendered for occupationally ill/injured employees.” In 2002, HealthSouth provided extensive health care services to two individuals insured by Wausau for job-related injuries. The patients assigned their insurance benefits to HealthSouth and it billed Wausau. Wausau audited the bills to determine the amount due under the then-current fee guideline propounded by the Texas Workers’ Compensation Commission, pursuant to the provision of the contract emphasized above. Wausau discounted HealthSouth’s bills for the two patients at issue, respectively from $65,693.25 to $16,609.84, and from $53,566.62 to $17,598.30. Wausau paid HealthSouth the discounted amounts and refused reconsideration. HealthSouth filed requests for medical dispute resolution with the division. The division dismissed the requests, stating: “This is a contractual dispute regarding a pre-negotiated contract with a preferred provider organization. Dates of service 11/13/02 through 11/17/02 [or 04/22/02 through 04/26/02] are in dispute. The Commission’s Medical Review Division does not have jurisdiction in medical disputes involving contract disputes between a healthcare provider and insurance company. This Dismissal does not constitute a review of this medical fee dispute. Therefore, your right to request a hearing at the State Office of Administrative Hearings is not applicable to this medical fee dispute.” HealthSouth then filed suit against Wausau, attempting to recover the discounted amounts pursuant to contract theories. Originally, HealthSouth sought relief as the assignee of the two patients. In an amended petition filed after the date of the order appealed from in this case, HealthSouth claimed a right to recover as a third-party beneficiary of the Wausau-First Health Group contract. Wausau filed a plea to the jurisdiction, arguing that the division had exclusive jurisdiction over fee disputes between healthcare providers and insurers and that HealthSouth had not exhausted its administrative remedies. The trial court granted the plea, dismissing HealthSouth’s claims “until [HealthSouth] exhausts its administrative remedies pursuant to the Texas Workers’ Compensation Act.” HealthSouth appealed. HOLDING:Affirmed. A plea to the jurisdiction, the court stated, is a dilatory plea. Its purpose is “to defeat a cause of action without regard to whether the claims asserted have merit.” The plea challenges the trial court’s authority to determine the subject matter of a pleaded cause of action. Dismissing a cause of action for lack of subject-matter jurisdiction, the court stated, is proper only when it is impossible for the plaintiff’s petition to confer jurisdiction on the trial court. Through Texas Labor Code �413.031(a)(1), part of the workers’ compensation statutory scheme, the Legislature has given a health care provider the right to an administrative review when the provider has rendered a medical service but has been paid a reduced amount for that service. HealthSouth, the court stated, did initially submit its claims to the division. However, once the division dismissed those claims, HealthSouth abandoned the statutory workers’ compensation system and initiated suit in the trial court below. If an administrative body has exclusive jurisdiction, the court stated, a party must exhaust all administrative remedies before seeking judicial review of the decision. Until the party has satisfied this exhaustion requirement, the trial court lacks subject matter jurisdiction and must dismiss those claims without prejudice to refiling. The court stated that the trial court correctly concluded it was the division’s exclusive duty to determine “the amount to be paid.” Finally, the court found that the trial court had no jurisdiction to review the dismissal order of the division in an appellate capacity. If the order is subject to judicial review, that review can only be had in the courts of Travis County, the court stated. The court held that the trial court correctly concluded that it was impossible for HealthSouth’s petition to confer jurisdiction on the trial court. Thus, the trial court correctly granted Wausau’s plea to the jurisdiction. OPINION:FitzGerald, J.; Moseley, O’Neill and FitzGerald, JJ.

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