Hospital filed an action against TennCare managed care organization (“MCO”) for breach of contract and unjust enrichment when MCO refused to pay Hospital’s standard charges for emergency services and follow-up care.

The audio of the oral argument in this game is available. 

Hospital was not part of MCO’s “provider network” under the TennCare regulations and therefore was “non-contract” provider.

MCO alleged Hospital was required to accept as payment the rate TennCare specified in its regulations.

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