Affirmed and Memorandum Opinion filed July 16, 2024.

In The

Fourteenth Court of Appeals

NO. 14-23-00368-CV

REGIONAL SPECIALTY CLINIC, P.A., Appellant

V.

SARNIE RANDLE, JR. AND S. A. RANDLE & ASSOCIATES, P.C., 

Appellees

On Appeal from the 157th District Court

Harris County, Texas

Trial Court Cause No. 2017-81941

M E M O R A N D U M O P I N I O N

In this appeal following a jury trial, appellant Regional Specialty Clinic, 

P.A., a health care provider, argues that the trial court abused its discretion in 

denying attorney’s fees after having granted appellant’s motion to dismiss 

appellees’ health care liability counterclaim. See Texas Medical Liability Act

(“TMLA”), Tex. Civ. Prac. & Rem. Code § 74.351(a). We conclude that 

appellees’ counterclaim was not a “health care liability claim” under the TMLA. 
2

Therefore, we hold that the trial court did not err in denying the Clinic’s request for 

attorney’s fees. We affirm.

Background

Patrick Cuba received medical treatment from the Clinic following an 

automobile accident. Cuba and the Clinic entered into an agreement, whereby the 

Clinic agreed to provide medical treatment pursuant to an assignment of benefits

and Cuba promised to pay his medical bills from the recovery, if any, of settlement 

proceeds against the other driver. Cuba subsequently settled his personal-injury 

suit with the alleged third-party tortfeasors; attorney Sarnie Randle, Jr. represented 

Cuba in that suit.

1

 When neither Cuba nor Randle paid Cuba’s bills upon demand 

from the Clinic, the Clinic sued Randle for tortious interference, money had and 

received, unjust enrichment, breach of a third-party beneficiary contract, and 

conspiracy to commit fraud and theft of services. 

Randle moved for summary judgment on all claims asserted against him, 

which the trial court granted. On appeal, this court reversed the portion of the trial 

court’s judgment rendering summary judgment in Randle’s favor on the clinic’s 

claim for breach of a third-party beneficiary contract, affirmed the remainder of the 

trial court’s judgment as challenged on appeal, and remanded the case to the trial 

court for further proceedings.

2

 Reg’l Specialty Clinic, P.A. v. S.A. Randle & 

Assocs., P.C., 625 S.W.3d 895, 907 (Tex. App.—Houston [14th Dist.] 2021, no 

pet.). 

1 We refer to the Randle appellees collectively as “Randle.”

2 The relevant part of our appellate judgment states, “We therefore order that the portions 

of the judgment that render judgment on this claim are REVERSED and ordered severed and 

REMANDED for proceedings in accordance with this court’s opinion.”
3

On remand, Randle asserted a counterclaim for negligence. Specifically, 

Randle alleged that the Clinic was negligent for failing to exercise reasonable 

diligence to notify Randle of its claim for payment sooner than five years after the 

service was rendered to Cuba and sooner than three years after Cuba settled his 

case and the settlement funds were distributed. The Clinic, asserting that Randle’s 

counterclaim was a health care liability claim, filed a motion to dismiss the 

counterclaim under the TMLA because Randle did not serve the requisite expert 

report. See Tex. Civ. Prac. & Rem. Code § 74.351. Randle filed a response, 

contesting the Clinic’s contention that the counterclaim was a health care liability 

claim.

The parties went to trial on the Clinic’s claims for conspiracy and breach of 

a third-party beneficiary contract. The trial court granted a directed verdict on the 

conspiracy claim, and the jury found against the Clinic on its remaining claim. 

The court did not submit, and Randle did not request, a jury question on his 

negligence counterclaim. 

The court signed a final judgment that the Clinic take nothing on its claims 

and that Randle take nothing on his counterclaim, thus denying all requested relief 

to all parties. The Clinic filed a motion for new trial. One request in the Clinic’s 

motion was that the trial court make a specific ruling on the motion to dismiss 

Randle’s counterclaim and award the Clinic its attorney’s fees under the TMLA. 

In his response to the motion for new trial, Randle argued that the Clinic was not 

entitled to attorney’s fees under the TMLA because his negligence counterclaim 

did not qualify as a health care liability claim, and, in any event, the Clinic did not 

prove up attorney’s fees.

The trial court signed two additional orders within its period of plenary 

jurisdiction. The first was an order denying the Clinic’s motion for new trial. 
4

Second, the trial court signed an order stating that the Clinic’s motion to dismiss 

Randle’s health care liability counterclaim is granted; that the counterclaim is 

dismissed with prejudice; and that the Clinic’s request for attorney’s fees is denied.

The Clinic appealed. 

Analysis

In a single issue, the Clinic argues that the trial court erred by denying its 

request for attorney’s fees under the TMLA.

A. Standard of Review

The dispositive issue in this appeal is whether Randle’s counterclaim 

qualifies as a “health care liability claim” under the TMLA. Because this case 

requires us to interpret statutory language to determine whether the act extends to 

Randle’s counterclaim, our review is de novo. Loaisiga v. Cerda, 379 S.W.3d 248, 

254-55 (Tex. 2012); Mem’l Hermann Hosp. Sys. v. Kerrigan, 383 S.W.3d 611, 

612, 613 (Tex. App.—Houston [14th Dist.] 2012, pet. denied).

B. Chapter 74 Health Care Liability Claims

The TMLA requires a claimant asserting a health care liability claim to serve 

on the defendant within a specified time an expert report and curriculum vitae of 

each expert listed in the report for each physician or health care provider against 

whom a liability claim is asserted. Tex. Civ. Prac. & Rem. Code § 74.351(a). A 

claimant’s failure to timely serve an expert report required by the TMLA requires 

the trial court to dismiss the claim and award reasonable attorney’s fees and costs 

to the affected physician or health care provider. Id. § 74.351(b).

The act’s requirements will not apply unless the claim at issue is a “health 

care liability claim.” “Health care liability claim” means a cause of action against 

a health care provider or physician for treatment, lack of treatment, or other 
5

claimed departure from accepted standards of medical care, or health care, or 

safety or professional or administrative services directly related to health care, 

which proximately results in injury to or death of a claimant, whether the 

claimant’s claim or cause of action sounds in tort or contract. Id. § 74.001(a)(13).

Randle contends that his counterclaim is not a health care liability claim for 

several reasons. On appeal, the Clinic first insists that Randle is barred from 

denying that his counterclaim is a health care liability claim because the trial court 

necessarily ruled otherwise in granting the Clinic’s motion to dismiss the 

counterclaim, and Randle did not file his own notice of appeal challenging that 

ruling. 

The Clinic is incorrect. A party must file a notice of appeal if it seeks to 

alter the trial court’s judgment or other appealable order. See Tex. R. App. P. 

25.1(c) (“[A] party who seeks to alter the trial court’s judgment or other appealable 

order must file a notice of appeal. . . . The appellate court may not grant a party 

who does not file a notice of appeal more favorable relief than did the trial court 

except for just cause.”). But when an appellee is satisfied with the relief granted 

by the trial court and merely wants to present additional, independent grounds for 

affirming the trial court’s judgment, no notice of appeal is required. See City of 

Austin v. Wittington, 384 S.W.3d 766, 789 (Tex. 2012); United Residential 

Properties, L.P. v. Theis, 378 S.W.3d 552, 557 n.3 (Tex. App.—Houston [14th 

Dist.] 2012, no pet); Dean v. Lafayette Place (Section One) Council of Co-Owners, 

Inc., 999 S.W.2d 814, 818 (Tex. App.—Houston [1st Dist.] 1999, no pet.).

Independent grounds for affirmance can be asserted on appeal as long as the 

appellee is not requesting greater relief than that awarded by the trial court. See

Dean, 999 S.W.2d at 818.
6

Randle is not seeking to alter the court’s judgment nor is he seeking any 

additional relief than that granted by the judgment. Randle asks us to affirm the 

judgment. Therefore, Randle was not required to file a notice of appeal. United 

Residential Properties, L.P., 378 S.W.3d at 557 n.3. Because the Clinic is 

appealing the portion of the trial court’s judgment denying its request for 

attorney’s fees, Randle may argue any independent ground for affirming the trial 

court’s ruling that was preserved in the record, including that Randle’s 

counterclaim is not a health care liability claim. See Dean, 999 S.W.2d at 818.

Accordingly, we proceed to consider whether Randle’s negligence 

counterclaim qualified as a health care liability claim under the TMLA.3 This 

requires us to consider the underlying nature of Randle’s counterclaim against the 

Clinic. See Yamada v. Friend, 335 S.W.3d 192, 196 (Tex. 2010) (to determine 

whether a cause of action falls under the statute’s definition of a health care 

liability claim, we examine the claim’s underlying nature). In Randle’s live 

pleading, he alleged:

Counter-Plaintiffs also contend that Plaintiff/Counter-Defendant was

negligent for failing to exercise reasonable diligence to notify either 

Randle, Cuba or any of the insurance carriers responsible for Plaintiffs 

unpaid bill for services rendered sooner than 5 years after the service 

was rendered to Cuba, in 2012, and sooner than 3 years after Cuba’s 

case had settled and proceeds distributed.

Randle clearly did not assert a claim against the Clinic for treatment, lack of 

treatment, or any departure from accepted standards of medical care or health care. 

The factual essence of Randle’s counterclaim was that the Clinic waited too long to 

submit its demand for payment or otherwise notify Randle that its bill for services 

3

It is undisputed that the Clinic is a health care provider. “Health care provider” means 

any person, partnership, professional association, corporation, facility, or institution duly 

licensed, certified, registered, or chartered by the State of Texas to provide health care. Tex. Civ. 

Prac. & Rem. Code § 74.001(a)(12)(A).
7

was unpaid. Randle asserted that he was not notified that the Clinic had not been 

paid for services provided to Cuba until more than three years after the settlement 

proceeds had been distributed. 

The Clinic contends that Randle’s counterclaim falls within the latter portion 

of the definition of health care liability claim because “hospital billing for 

healthcare services rendered is a ‘professional or administrative service directly

related to health care.’”

Again, the Clinic is incorrect. “Professional or administrative services” 

means “those duties or services that a physician or health care provider is required 

to provide as a condition of maintaining the physician’s or health care provider’s 

license, accreditation status, or certification to participate in state or federal 

health care programs.” Tex. Civ. Prac. & Rem. Code § 74.001(a)(24) (emphasis 

added). The Clinic does not assert, much less establish, that it is required to 

provide its billing services as a condition of maintaining any license, accreditation 

status, or state or federal certification. The Clinic relies on McAllen Hospitals, 

L.P. v. Gomez, No. 13-12-00421-CV, 2013 WL 784688, at *3-4 (Tex. App.—

Corpus Christi Feb. 28, 2013, no pet.) (mem. op.), in which the court held that a 

patient’s complaint that he was “overcharged for services rendered” constituted a 

health care liability claim. The court stated that “hospital billing appears to fit 

within the definition of ‘professional or administrative services.’” Id. at *3. 

Gomez is distinguishable, however, because the court in that case noted that a 

hospital is statutorily required to prepare and provide, on request, an “itemized 

statement of the billed services provided to the person.” Id. (citing Tex. Health & 

Safety Code § 311.002(b)). Unlike the health care provider in Gomez, the Clinic is 

not a hospital, and it identifies no similar requirement it must follow.
8

Even if we were to assume that the Clinic’s billing practices are professional 

or administrative services, the Clinic has not shown that the billing practice at issue

was “directly related to health care.” In Gomez, for instance, the court held that, 

because Gomez alleged that he was billed an unreasonable amount “for the 

healthcare services rendered,” the complained-of conduct was directly related to 

health care. See id. In this case, Randle is not complaining that the Clinic charged 

too much for the health care services rendered to Cuba or that the Clinic billed for 

a service not performed. See id.; Milton v. Nguyen, No. 14-16-00883-CV, 2017 

WL 4017872, at *3 (Tex. App.—Houston [14th Dist.] Sept. 12, 2017, no pet.)

(mem. op.) (allegations that a health care provider did not perform all services 

billed constituted a health care liability claim). Rather, the complained-of conduct 

is that the Clinic waited too long to collect on a bill, which is not directly related to 

any provision of health care to Cuba.

The Clinic also relies on cases holding that the maintenance of accurate 

medical records falls within the definition of professional and administrative 

services directly related to health care. See Baylor Scott & White, Hillcrest Med.

Ctr. v. Weems, 575 S.W.3d 357, 364 (Tex. 2019); Rittinger v. Davis Clinic, No. 

14-19-00472-CV, 2021 WL 2425834, at *5 (Tex. App.—Houston [14th Dist.] June 

15, 2021, no pet.) (mem. op.) (“The duty to provide medical records to the patients 

cannot be separated from the duty to maintain them.”). But a health care 

provider’s demand for payment is not a “medical record,” as discussed in those 

cases. A medical record must be created during the patient’s care and “must 

contain accurate data and information pertaining to the patient based on actual 

findings, assessments, evaluations, diagnostics or assessments as documented by 

the physician.” 22 Tex. Admin. Code § 165.1(a), (a)(10) (“Medical Records”). 

Thus, Weems and Rittinger are inapposite.
9

We hold that Randle’s counterclaim is not a health care liability claim, as 

that term is defined in the TMLA. See Tex. Civ. Prac. & Rem. Code 

§ 74.001(a)(13). Because the claim is not subject to the act’s requirements, the 

trial court did not abuse its discretion in denying the Clinic’s request for its 

attorney’s fees. Id. § 74.351(b).

Conclusion

We affirm the trial court’s judgment.

/s/ Kevin Jewell

Justice

Panel consists of Justices Wise, Jewell, and Spain.