### TEXA S C OU R T OF A PPEAL S, THIR D DIST R ICT , AT AU STIN

NO. 03-0 7 -00 007 -CV
App e lla nt s, HC A H e alt hc ar e Co r por at ion , e t a l. \ \ C r os s- App e lla nt s, Al be r t B e tt s, Jr . a nd Texas Depart m ent of In surance, Division of Workers' Com pensation
v. Appellees, Texas Depart m ent of In surance; Alber t Bett s, Jr. and Texas Departm ent of Insu rance, D ivision of Workers' Com pensation et al.\\ Cross-Appellees, HCA Healthcar e Co r por at ion , e t a l.

F ROM THE DISTRICT CO URT OF TRAVIS COUNTY , 201S T JUDICIAL DISTRICT NO. D-1- GN-06- 0001 76 , HO NORAB LE STEP HEN Y ELENOSK Y , JUDGE PRESIDI NG

O P I N I O N
On J anuar

y 17, 2006, HCA Hea lthcare Corporation, Texas Hea lth Resources, Inc., the Te xas Ho sp ita l As so c iatio n, and oth e r ho sp ita ls and ho sp ita l sy ste ms ( “ the Ho sp ita ls” ) f ile d s uit for de clar atory and inj unctive relief ag ainst the Texas Depa rtment of Insuranc e (“ the Depa rtment”), the De p ar t m ent’s Division of Workers’ Compensation (“DWC”), and A lbert B etts, J r., Commi ssioner of DWC. Texas Mutua l I nsuranc e Company

(“Te x as Mutual”) , Fa

rmers Insuranc e Ex chang e, Truc k I nsuranc e Exchang e, Mid-C entury I nsuranc e Company , and the Te x as Association of School Boa

rds Risk Manag ement Fu n d (c o llectively , “the Insurer s”) inter vened in support of D WC r e g ar d in g th e H o s p it a ls ’ r e qu e s t t h a t t h e tr ia l c o u rt r e v e r s e 1 , 4 0 6 d e c is io n s is s u e d b y D WC afte r September

1, 2005. Texas Mutual filed a decla ratory judgme nt action ag ainst DWC reg arding t h e r i gh tt o a c o n t es t edca s e h ea ri n g.2 Te xas M utu a l mo ve d f

or summa ry jud g me nt o n it s c la im t o a ri g ht t o a c on te ste d c a se hear ing a

nd for pa

rtial summary

judgme nt ag ains t t h e Hospitals’ reque st to rever se the 1,406 decisions issued by DWC. The Hospitals moved for summary judgme nt on their claim to a
r ig h t t o a c o n te s te d

c a s e h e ar in g an d

th e ir r e qu e s t t o r e v e r s e th e d e c is io n s is s u e d b y D WC
. D WC
mov e d f or summa ry jud g me nt i n o pp os iti on

to b oth the Ho sp ita ls a

nd Te xas M utu a l. The trial c ourt g rante d the Hospitals’ and Te x as Mutual’s motions for summary judgme nt on t h ei r cl ai ms to a rig ht to a hear ing in medic al disputes broug ht pursuant to former section 413.031 of the T exas L abor Cod e enti tled “Medic al Dispute Resolution.” See Act of May 30 , 2 00 5, 79 th L e g ., R.S. , c h. 26 5, § 3 .2 45 , 2 00 5 T e x. Ge n. L aws 55 3- 54 (later a me nd e d in 2007). The c ourt d enied the Hospitals’ reque st to rever se the 1,406 orde rs issued by DWC. The Hospitals appea led the cour t’s ref usal to set aside the D WC decisions, and DW C appealed the court’s de clar ation that former subsection 413.031(k) of

the labor code was fa cially unconstitutional fo r f ai l u re t o p ro v i d e a no p p o rt u n i t y fo r aco n t es t edca s e h ea ri n g. For t h e reasons set for

th below, we a ffirm in par t the trial court’ s denial of the Hospitals’ reque st to set aside the 1,406 decisions issued by DWC and r ever se in part the tr ial court’s order decla ring that former

subsection 413.031(k) is fa cially unconstitutional and rende r judg ment that f or me r s ub se c tio n 4 13 .0 31 (k ) o f t he la bo r c od e is f

a c ia lly c on sti tut ion a l.
F ACTUAL AND P ROCEDURAL BACK GR OUND Pursuant to the medical dispute re solution process set for th in section 413.031 of the labor code, a

h o s p it a l, o r

o th e r h e a lt h c ar e p r o v id e r , th a t d is a g r e e s w it h th e a mo u n t o f

p ay me nt remit t ed b y a workers’ c ompensation insuranc e ca rrier is entitled to a review

by DWC of theTh e iss ue of wh e the r ho sp ita ls a re e nti tle d to a dd iti on a l pa y me nt f or se rv ic e s p re vio us ly 1 paid pursuant to the 1992 Fe e Guideline has be en the subjec t of ong oing litig ation in severa l leg al venues. This Court’s opinion in All Saints Health S ys tem v. Tex as W

orkers’ Compe nsation Commission , 125 S.W .3d 96 (Tex. A pp.—Austin 2003, pet. denied) provides a detailed fac tual and proce dural ba ckg round datingback to 1987. 3 provided medic al servic es to deter mine the amount of pa

y ment due the he alth car e provide r. DWC’s
ro le in re so lvi ng me dic a l fe e dis pu te s, a s c on du c te d b y its dis pu te re so lut ion

of fi c e rs , is to a dju dic a te the pay ment due, in acc ordanc e with the relevant st atutory provisions and DW C rules, and to issue a dec ision. See Tex. L ab. Code Ann. § 413.031 ( West S upp. 2008).

I n Texas Hospital Ass’n v. Texas W orkers’ Compe nsation Commissi on , 911 S.W .2d 884 (T e x. Ap p. —Aus tin 19 95 , w ri t de nie d) , th is C ourt re nd e re d v oid

the Te xas Wor

ke rs ’ Compensation Comm ission’s (“ T W C C ”) 1992 H ospital I npatient Fe e Guideline that was promulg ated to g overn pa y ment to hospitals by

insurance car

ri er s (“ t he 1992 F ee Guideline”)
. 17 Tex. Reg . 4949 (1992) repeale d by 22 Tex. Reg. 6264 ( 1997). Afte r the supre me cour t denied revie w of this Court’s holding, Te x as hospitals, many of which a

re a party to t h i s ap p eal, lodged thousands of administrative a ppeals by filing me dical dispute re solutions wi t h T W C C seeking additional pay

ment for claims paid pursuant to the voi d 1992 Fe e Guideline. I n 1999, TWCC issued 1 over 200 me dical dispute dec isions that denied any additional pay

ment, and the Hospitals appea led tho se de c isi on s to the State Of fi c e of Ad min istra tiv e He ari ng s ( SOA H) fo r c on te ste d c a se he ari ng s. I n 2005, the l eg islature enacted comprehe nsive worke rs’ c ompensation ref orm that abolished TWCC and made other change s to the dispute-resolution proce ss. See Act of May 30, 2005, 79th L eg ., R.S., ch. 265, 2005 Tex. Gen. L aws 469-611. A s part of that refor m, the le g isl a tur e tr ans fe rr e d ju

ri sd ic tio n o ve r t he pen di ngc la ims to D WC. A c t of May 30 , 2 00 5, 79 thPrior to being amende d in 2005, Tex. L ab. Code § 4 1 3
. 0 3 1 (k) read in pe rtinent part a s 2 follows: “Except as provided by Subsection ( l ), a party

to a medica l dispute that remains unre solved afte r a r eview of

the medica l service under this section is entitled to a hear ing. T he hea ring shall be conducte d by

[S OAH] within 90 day s of re ceipt of a reque st f or a hear ing in the manner provided for a contested c ase unde r Chapter 2001, Gover

nment Code (the a dminist rative pr ocedur e law)
. . .” Act of June 17, 2001, 77th L eg . R. S., ch 1456, § 6.04, 2001 Tex. Gen. L aws 5187. After being amende d in 2005, § 413.031(k) re ad in pe rtinent part a s follows: “Except as provided in Subsection ( l ), a party to a medical dispute that rema ins unresolved a fter a revie w of the medical se rvice under this sec tion may seek judicial revie w. . . J udicial re view under this subsection shall be conduc ted in the manner p r ovided for judicia l reviewof conte sted ca ses under Subchapter

G, Chapter 2001, Gove rnment Code.” A ct of May 30, 2005, 79th L eg ., R
. S
. , ch. 265, § 3.245, 2005 Tex. Gen. L aws 554 (he reina fter, “ former § 4133.031(k)” ). I n 2007, the leg islature ag ain made c hang es to the dis pute-re solution process. Eff ective 3 Se pte mbe r 1 , 2 00 7, § 41 3. 03 1( k) re a ds in p e rt ine nt p art a s f oll ow s: “ A p art

y to a me dic a l di sp ute . . . that rema ins unresolved after a re view of the medical se rvice under this sec tion is entit led to a hear ing. A hea

ring under this subsection shall be c onducted by [S OAH]. . . .” Ac t of J une 15, 2007, 80th L eg ., R.S., ch. 1007, § 1, 2007 Tex. Gen. L aws 3531. 4 L eg ., R
. S
. , ch. 265, § 1.003, 2005 Te x . Gen. L aws 470. Ac cording ly , on September 1, 2005, jurisdiction over the c laims not before SOAH was tra nsfer red to DWC. Those claims that had not y et been sent to SOAH wer e g overne d by the new version of Texas L abor Code § 413.031( k) that
n o l o n ger en t i t l eda p ar t y

t o a h ea ri n g. Be tween November 2005 and J anuar y 2006, DWC i ssued 2 the 1 , 4 0 6 d e c i s i o n s t h a t ar e t h e s u b j e c t o f t h i s a

p p e a l
. A f

t e r d i s c o v e r i n g D W C h a d iss ue d th os e de c isi on s, the Ho sp ita ls f ile d s uit in d istri c t c ourt
. 3
DI SCU SSIO N Stand ard of Review

We re vie w the tr ia l court ’s g ra nt o f s umm ary

jud g me nt de novo
. ValenceOperating Co. v . D or se tt , 164 S.W. 3d 65 6, 66 1 ( Te x. 20 05 ); Combs v. STP Nuclear Operating Co. , 239 S.W .3d 264, 269 (Tex. A

pp.—Austin 2007, pe t. denied). When both par ties move for summar

y judgme nt5

and the tr ia l c ourt

g ra nts on e mot ion and de nie s the oth e r, the re vie wi ng c ourt sh ou ld r e vie w b oth parties’ summary judgme nt e vidence , deter mine all questions pr esente d, and rende r t h e j u d gm ent that the trial cour

t should have re ndere d. Dow Chem. Co. v. Bright , 89 S.W .3d 602, 605 (T e x. 20 02 ); STP Nuclear Operating , 239 S.W .3d at 269.
The Fac ially Cons titutional Chal lenge

Th e re are tw o ty

pe s of ch a lle ng e s to the c on sti tut ion a lity of a statut e : fa c ia l and a sapplied. Michae l C. Dorf, Facial Challenges to State and Federal Statutes , 46 Stan. L . Rev. 235, 23 6 (19 94 ). F a c ia l cha lle ng e s ar e dis fa vo re d an d g e ne ra lly pe rm itt e d only in the c on te xt of the F ir st Amendment. National

Endowment for the Arts v. Finley , 5 24 U. S. 5 69 , 5 80 (1 99 8) ; STP Nuclear Operating , 2 39 S.W. 3d

a t 27 3- 74 n. 8. A p art

y se e kin g to i nv a lid a te a

statut e “ on its fa c e ” be ars a he a vy burd e n o f d e mon str a tin g tha t th e statut e is unc on sti tut ion a l in a ll o f i ts a pp lic a tio ns . W as hingto n S

tate Gran ge v. W

as hin gto n S

tate Re pu b. Pa rty , 552 U.S. 442, __, 128 S. C t. 1184, 1190 (2008) ( citing United States v. Salerno , 4 81 U. S. 7 39 , 7 45 (1 98 7) ); STP Nuclear Operating , 239 S .W.3d at 273-74 n. 8; se e Te x as W or k e rs’ Com p. Com m’n v . G ar c ia , 893 S.W .2d 504, 518 (Tex. 1995). “To sustain a f acia l challeng e, the c halleng ing pa rty must establish that the statute, by its terms, alway s operates unconstitutionally .” Barshop v. Me d i n a Underground W ater & Con se rv ati on Di

st. , 618 S.W .2d 618, 627 (Tex. 1996). I n contra st, a party making an as- applied challeng e must only

show that the statute, thoug h g ener ally const i t utional, is unconstitut ional beca use of the w ay

in which it was applied to that party in a par ticular c ase. Se e Ga rc ia , 893 S.W .2d
a t 51 8 n .1 6; STP Nuclear Operating , 2 39 S.W. 3d a t 273- 74 n. 8. Whe n a cou rt inv a lid a te s a

statut e
on its fa c e , the statut e may no t be e nf or c e d und e r a

ny c ir c ums tanc e s; b ut whe n a c ourt fi nd s a statut e6

unconstitutional as applied t o a particular se t of fac ts, the statute may be constitutionally

enfor ced to differ ent fa cts. See STP Nuclear O perating , 239 S.W .3d at 273-74 n

. 8; Dorf, Facial Challenges to State and Federal Statutes , 46 Stan. L . Rev. at 236.

DWC a rgue s th e tr ia l co urt e rr e d in de c lari ngthat f

or me r s ub se c tio n 4 13 .0 31 (k ) i s fac ially unconstitutional on the basis that “it fails to affor d par ties to a medica l dispute . . . an opportunity

for a hear ing in whic h witnesses ar e sworn a nd the par ties can r ebut adve rse e vidence
and c ro ss- e xami ne a dv e rs e wi tne sse s b e fo re a fi na l ord e r is issu e d. ” F or that f or me r s ub se c tio n to be fa c ia lly

un c on sti tut ion a l, D WC a sse rt s th e re c an b e no sit ua tio ns in whic h li ve te sti mony or c ro ssexamination would not be a constitutional c ommand. Howeve r, DWC contends there a re situations in which a pa

p e r - r e v ie w p r o c e s s w it

h o u t a h e ar in g is s u f

f ic ie n t. F o r

e xa mp le , in

ma n y me d ical dis pu te s, a

summa ry -j ud g me nt- lik e pr oc e ss i s a pp ro pr ia te wh e n no iss ue s o f m a te ri a l f a c ts e xist. DWC not es that, indee d, the Insurer s conce ded the statute has valid applications when they stated in their brief

to this C ourt that “proba bly most medical disput es u n d er § 413.031 will be resolved without need for

a conte sted ca se hea

ring .” DWC thus argues t hat, because the former subsection has some valid applications, the trial court er red in de clar ing it fa cially unconstitutional. Medica l dispute resolution (MDR) is d ef i n ed in section 133.305 of DWC rules
a s f oll ow s: A p ro c e ss f

or re so lut ion

of on e or mor e of the fo llo wi ngdis pu te s: (A) a medica l fee dispute; or (B ) a medica l nece ssity dispute, which may

be: ( I ) a pre aut h o ri z ati on or c on c ur re nt m e dica l ne c e ssi ty dispute; or7 ( i i ) a retr o s p e c ti v e me dical nece ssity dispute.
2 8 T ex . Ad m i n . C o d e § 1 3 3
. 3 0 5 ( a ) ( 3 ) ( D i s p u t e o f M ed i ca l Bi l l s , M DR

– Ge n er al ), 3 1 T ex . R eg. 10314, eff

ective D ece mber 31, 2006, amende d by 33 Tex. Reg. 3954, e ffe ctive May 25, 2008. A m e dic a l f

e e dis pu te is d e fi ne d in

se c tio n 1 33 .3 05 , in

pe rt ine nt p art , a s f

oll ow s:
A dis pu te that in vo lve s a

n amou nt o f p ay me nt f or no n- ne tw or

k h e a lth car e re ndere d to an injured e mploy ee ( employ ee ) that has be en deter mined to b e m edically

nece ssary

and appr opriate f

or trea tment o f t hat employ ee’ s compensable injury . The dispute is resolve d by [DWC] p ur su ant t o [D WC] ru le s, inc lud ing§ 1 33 .3 07 of thi s subchapte r (r elating to MDR of Fe e Disputes). The following ty pes of disputes ca

n be a me dical fe e dispute: (A) a hea lth care provider ( provider)
. . . dispute of an insuranc e ca

rrier (ca rrier ) re duction or denial of a

medical bill . . . .
Id. § 133.305(a) (4).

Pr eautho ri zat ion

or c on c ur re nt m e dic a l ne c e ssi ty

dis pu te s are de fi ne d in
se c tio n 1 33 .3 05 a s f

oll ow s: A dispute that involves a re view of a dverse deter mination of network or non-ne twork hea lth care requiringprea uthorization or concurr ent revie w. The dispute is revie wed by an indepe ndent re view org anization (I RO) pursuant to the I nsuranc e Code, the L abor Code and re late d r ule s, inc lud ing§ 1 33 .3 08 of thi s su bc ha pte r ( re latin g to MDR by I ndepende nt Review Org anizations).
Id. § 133.305(a) (7).

Re tr os pe c tiv e me dic a l ne c e ssi ty dis pu te s are de fi ne d in se c tio n 1 33 .3 05 a s f oll ow s:8 A d isp ute tha

t in vo lve s a

re vie w o f t

he medic a l ne c e ssi ty

of he a lth car e alr eady

provided. The dispute is reviewe d by an I RO pursuant to the I nsuranc e Code, L abor Code and related rul es , i n cluding § 133.308 of this subchapter
. Id. § 133.305(a) (10).

As s et fo rth in their def initions , medical ne cessity disputes are revie wed by independe nt revieworg anizations (I ROs). I n perf orming a re view of me dical nec essity , an I RO may reque st that DWC require an examination by a designated doctor and dire ct the employ ee to attend the examination. 28 Tex. Admin. C ode § 133.308(l) ( MDR by I ndepende nt Review Org anizations), 31 Tex.Reg. 10314, e ffe ctive De cembe r 31, 2006, amende d by 33 Tex
. R eg. 3954, eff ective May 25, 2008. The designated doctor examines the employ ee and fil es a repor t with the I RO. Id. The I RO rende rs a de cision and sends it to the parties. Id. § 133.308(m), (n)
.

The c ase be fore this Court clearly conce rns m edica l fee disputes. See 28 Tex. Admin. Code § 133.305(a) (4)( A). F ormer se ction 413.03(k) r eads in pe rtinent part a s follows: “Except as provided in Subsection ( l ), a pa rty to a me dic al d

isp utethat rema ins unresolved a fter a revie w of the medical se rvice under this sec tion may seek judicia l review . . . .” (Empha sis added.) A medica l fee dispute is a ty

pe of me dical disput e t o wh i ch for mer sec tion 413.031(k) per tains. See id. § 133.305(a) (3). However , medical necessity disputes, that is, retrospec tive, prea uthorization, and
concur rent medic al necessity disputes, are also medical disput es t o which for mer sec tion 413.031(k) perta ins. Id. The Hospitals, se eking to inva lidate former section 413.031(k) “on its fa ce,” bear the burden of showing that the sec tion is unconstit utional in all of its applications. Se e W as hin gto n S

tate9

Grange , 552 U.S. 442, __, 128 S. Ct. at 1190. The Hospitals ha ve asse rt ed t h at fo rm er section 413.031(k) operates unconstitutionally in medical fe e disputes. Howe ver, the Hospitals have
no t argue d, muc h le ss de mon str a te d, that fo rm e r se c tio n 41 3. 03 1( k) op e rate s un c on sti tut ion a lly in
me dic a l ne c e ssi ty

dis pu te s, dis pu te s to wh ic h this se c tio n als o pe rt a ins . Fo r e xamp le , th e Ho sp ita ls have f ailed to show how ora l presentation of evidenc e and c ross-examination are absolutel y essential in the s ituation wher e an I RO deter mines, based on an employ ee’ s medical recor ds and a desig nated do c tor ’s re po rt , th a t th e he a lthc are pr ov ide d a n in div idu a l e mpl oy e e who ha s b e e n p e rs on a lly examined by

a designated doctor is medically nece ssary . Such a demonstration is i mportant in light of the Sup re me Court ’s de te rm inatio n th a t r ou tin e , s tand ard , an d unb ia se d w ri tte n me dic a l r e po rt s by ph y sic ian s pe c ia lis ts c on c e rn ingind ivi du a ls w ho m th ey hav e pe rs on a lly e xami ne d a

re re lia ble and probative, such that the “ specte r of que stionable cre dibi l i ty and ver acity

is not present.” Mathews v. Eldridge , 4 2 4 US 3 1 9 , 3 4 4 (1 9 7 6 ) (c i t i n g an d qu o t i n g Richardson v. Pe rales , 402 US 389, 404-05, 407 (1971) ). B eca use the Hospitals ha

ve neg lected to de monstrate that former section 413.031(k) operates unconstitutionally in me dical nece ssity disputes, w e find that the Hospitals have fa ile d to me e t th e ir

burd e n o f s ho wi ngthat form er sectio n 4 13 .0 31 (k ) i s unc on sti tut ion a l in a ll of its a pp lic a tio ns . Finding that the Hospitals have failed to meet their bu rden of showing that former section 413.031(k) is unconstituti onal in all of its applications, we r ever se the trial c ourt’s decla ration that for

mer subsec tion 413.031(k) is fac ially unconstitutional and rende r judg ment that the fo rm e r s tatut e is f

a c ia lly c on sti tut ion a l.10

Re vie w of th e 1, 40 6 D WC De c isi ons

I n their second issue, the Hospitals asser t that the trial court e rre d in refusingto set aside the 1,406 de cisions issued by DWC between Nove mber 1, 2005 a nd mid-J anuar

y 2006. They
c on te nd the y we re no t r e qu ir e d to fo llo w t he pr oc e dure s of a fa c ia lly un c on sti tut ion a l statut e and did not have to file substantial e vidence re v i ew appea ls of those dec isions because the administrative d e c is io n s is s u e d p u r s u an t to th a t un c o n s ti tuti o n a l st a tute ar e v o id
. T h e H o s p it a ls a ls o ar g u e D WC iss ue d th os e de c isi on s w ith ou t g ivi ng the Ho sp ita ls pr op e r no tic e . Th e Ho sp ita ls c la im that, b e c a us e they proper ly challeng ed the e ntire statute as void, inclu d i n g its requireme nt to appeal issued decisions to the district c ourt within 30 day s, the trial court had jurisdiction to set aside a nd rema nd the de c isi on s to DWC.

Ho we ve r, DWC an d th e I ns ur e rs c or re c tly po int ou t th a t th e tr ia l c ourt

pr op e rl y deter mined that it lacked jurisdiction to s et asi de the 1,406 de cisions. Accor ding to f ormer subsection 413.031(k), judicia l reviewunder that subsection is to be conducte d in the manner provided for

judicial revie w of c ontested ca ses under the A d mi n istrative Proce dure A ct (“ the APA”) , that is, chapter

2001, subchapte r G, of the g overnme nt code. Act of May 30, 2005, 79th L eg ., R.S., ch. 265, § 3.245, 2005 Te x . Gen. L aws 554. Pursuant to the APA, a party initiates judicial review by filing a petition not la t er t h an the 30th day afte r the date on which the de cision is final and appea lable. Te x . Gov’t Code Ann. § 2001.176( a) ( West 2008).

I t is undisput ed that the Hospitals have not filed sui t for judicial revie w of a ny of the 1, 40 6 D WC de c isi on s. Th e 1, 40 6 de c isi on s we re fi na l and a pp e a la ble wh e n is su e d b y

DWC b e c a

us eDWC i s not a “state ag ency” for APA purposes. Tex. Gov’t C ode Ann. § 2001.003(7)( D) 4 (West 2008). Only

cer tain APA provisions apply to DWC proce eding s, and those provisions do not inc lud e g ov e rnme nt c od e § 2 00 1. 14 4, wh ic h cont ains the mot ion fo r r e he ari ngre qu ir e me nt. Tex. L ab. Code Ann. § 401.021( 1) (West 2006). 11 a motion for re hear ing is not re quired. I n s o m e case s, the Hospitals failed to appe al the issued 4 decisions beca

use, due to inc orre ct addre sses, they did not r ece ive notice. The notice proble m was ultimately

cure d, howeve r, when those decisions were delivered to the Hospi tals’ counsel. A notice problem only

cre ates a differ ent starting d ate f or the time to seek judicia l review ; it does not eliminate the re quirement. See M eador-Br a dy Mgm t. Corp. v. Texas Motor VehicleComm’n , 86 6 S. W.2 d 5 93 , 5 96 (T e x. 19 94 ); Com me rc ial Life In s. Co. v . S tate Bd . o f I ns . , 774 S.W .2d 650, 651-52 (Te x . 1989).

The Hospitals a lso c ontend the 1,406 dec isions are void bec ause D WC issued them pursuant to an unc onstitut ional statute; theref ore, the Hospitals are excused from having to pe tition for judicial revie w to se t a side those decisions. We disa g ree . Alleg ing a constitutional viol ation or defe ct does not excuse a party from comply ing with applicable law, whe ther that lawrequire s further administrative proc edure s or the filing of substantial evidenc e re view appea ls to pre serve err or. See MA G- T, L. P. v . Trav is C e nt. Ap prais al D ist
. , 161 S.W
. 3 d 6 17, 632 (Tex. App.—Austin 2005, pet. denied) (alleg ation of constitutional misdeeds is in s u ff i cient to avoid the administrative proc ess).

The APA re quirement set f orth in se ction 2001.176(a) of the g overnme nt c ode that suit for judicial revie w must be filed within 30 day s of the DWC decis i o n b ecoming fina l and appea lable is jurisdictional. See H eart Hosp. IV, L.P. v. King , 116 S.W .3d 831, 83512

(Tex. App.—Austin 20 0 3 , p et
. denied) . Be cause the Hospitals failed to file the ir petitions for judicial revie w of the 1,406 D WC decisions within the require d 30-day time frame , the district court was without jurisdiction to consider them. Finding that the t rial court lacke d jurisdiction to set aside the 1,406 DWC decisions that were not dir ec t l y b efore it in this declaratory -judg ment action, we
ov e r r u le th e H o s p it a ls ’ s e c o n d is s u e an d a f f ir m th a t p art o f th e tr ia l c o u rt’ s o r d e r deny ing the Ho sp ita ls’ re qu e st t o s e t a sid e tho se DWC d e c isi on s.
CO NC LU SION We affir m in part the district court’s order denying the Hospitals’ reque st to set aside the 1, 40 6 de c isi on s issu e d by DWC be tw e e n N ov e mbe r 1 , 2 00 5 a nd mid -Janu ary

20 06 and re ve rs e in p art the tr ia l c ourt ’s or de r de c lari ng that f or me r s ub se c tio n 4 13 .0 31 (k ) i s f a c ia lly un c on sti tut ion a l,
re nd e ri ngjud g me nt t

hat f or me r s ub se c tio n 4 13 .0 31 (k ) i s f a c ia lly c on sti tut ion a l.

David Pury ear , J ustice Be fore J ustices Patterson, Pury ear and Pember

ton Affir med in part; Rever sed and Rende red in pa rt Filed: De cembe r 18, 2009