Business Law

Saini v. Sutter Health (June 17, 2022, A162081) __ Cal.App.5th __ [2022 WL 2643451], ordered published July 8, 2022

Hospitals have no duty to post signs disclosing the ER fees published in the chargemaster.

After plaintiff Dar Saini was treated at a Sutter Health emergency room, he received a $4,593 bill that included a $2,811 evaluation and management services (EMS) fee. Saini sued Sutter, alleging that its failure to disclose the EMS fee in emergency room signage violated both the unfair competition law (UCL) and the Consumer Legal Remedies Act (CLRA). Under the Payers’ Bill of Rights, California hospitals must publish a “charge description master” (chargemaster) identifying uniform charges for their services and post notices informing patients how to access the chargemaster. Although Sutter had disclosed the EMS fee in its chargemaster and provided the required notice of how to access it, Saini argued that Sutter had a separate duty to notify prospective patients of its intent to bill the EMS fee before providing emergency services. The trial court sustained Sutter’s demurrer, ruling that it had no duty to separately post notice of the EMS fee in its emergency room. Saini appealed.

The Court of Appeal affirmed, following a recent decision in Gray v. Dignity Health (2021) 70 Cal.App.5th 225 that rejected an essentially identical CLRA claim. The court rejected Saini’s contention that Gray was wrongly decided, agreeing with Gray that “ ‘requiring such disclosure would be inconsistent with the “strong legislative policy” reflected in the applicable “multifaceted statutory and regulatory scheme” designed “to ensure that emergency medical care is provided immediately to those who need it, and that billing disclosures not stand in the way of that paramount objective.’ ” The court also noted that the UCL requires only reasonable notice–not “ ‘the best possible notice.’ ” Because Sutter complied with its statutory and regulatory disclosure requirements, it did not conceal or have “exclusive knowledge” that it would charge the EMS fee and therefore owed no additional disclosure duty under the UCL or CLRA. The court further agreed with Gray that state and federal legislative bodies are in a superior position to balance the need to ensure full disclosure of fees against the need to provide prompt emergency medical treatment.

The bulletin describing this appellate decision was originally prepared for the California Society for Healthcare Attorneys (CSHA) by H. Thomas Watson and Peder K. Batalden, who are partners at the appellate firm Horvitz & Levy LLP, and is republished with permission.

For more information regarding this bulletin, please contact H. Thomas Watson, Horvitz & Levy LLP, at 818-995-0800 or

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