Business Law Health Law Committee

Residue of a special needs trust must reimburse DHCS for Medi-Cal payments to deceased beneficiary. Read more

The California Department of Health Care Services prepared a Medi-Cal audit of Hoag Hospital’s 2009 cost report, determining that Hoag had to pay more than $2.4 million in reimbursements mandated by Assembly Bills (AB) 5 and 1183, which reduced the amount of certain Medi-Cal payments. Hoag filed a timely administrative appeal contesting the legality of the Assembly bills and the reimbursement deductions based on federal and state laws and constitutions. Hoag later filed a second appeal requesting that its existing appeal also address an alleged $620,903 calculation error to be corrected if AB 5 and 1183 were lawful. The ALJ dismissed Hoag’s first appeal for lack of jurisdiction and dismissed its calculation error appeal as untimely. Read more

Ethan Lomeli’s guardian sued medical care providers for his birth injuries. Through Medi-Cal, the California Department of Health Care Services paid for his medical care before and during the lawsuit. After Lomeli settled with defendants for $4 million, the Department moved to impose a $267,159.60 lien on the settlement, seeking reimbursement for the care it provided. The trial court granted the motion, and Lomeli appealed. Read more

The Medical Board of California issued a subpoena demanding that Dr. Ron Kennedy produce the medical records of three minor patients for whom he had provided vaccination exemptions. When Dr. Kennedy refused to comply, the Board filed a petition in the superior court under Government Code section 11187 to compel compliance. The superior court granted the petition and ordered Dr. Kennedy to produce the records, then denied Dr. Kennedy’s request to stay that order pending appellate review. Dr. Kennedy appealed and filed a petition for a writ of supersedeas seeking a stay of the production order pending appeal. Read more

The Department of Consumer Affairs (DCA), which oversees the Medical Board, investigated whether Dr. Marc Wolfsohn, a pain management specialist, was overprescribing opiate painkillers. Based on a report from the Controlled Substance Utilization Review and Evaluation System (CURES), investigators identified five patients who may have been prescribed excessive doses. The DCA served a subpoena duces tecum on Dr. Wolfsohn to produce more than two years of medical records for the five patients. After Dr. Wolfsohn objected on patient privacy grounds, the DCA secured an order compelling production. Dr. Wolfsohn appealed. Read more

MICRA notice of intent to sue does not toll Government Claims Act deadlines. Plaintiff Jamie Harper was allegedly injured during a surgery at the Modoc Medical Center, a public entity. Almost a year later, her counsel sent Modoc notice of intent to sue, as required by MICRA. (See Code Civ. Proc., § 364.) Modoc treated the notice as a government claim, and rejected it as untimely. (See Gov. Code, § 911.2, subd. (a) [notice of claim must be submitted within 6 months after the cause of action accrues].) Read more

Health care trades or businesses in which real estate is a necessary component in the delivery of health care goods and services should be aware of the business interest deduction limitation that was enacted at the end of 2017 and became effective for tax years beginning after December 31, 2017. Read more

After announcing in December that it would intervene in a qui tam action under the False Claims Act against Sutter Health and Palo Alto Medical Foundation, the US Department of Justice filed its complaint-in-intervention in the Northern District of California on March 4, 2019. Read more

The Medical Board of California received an anonymous complaint alleging that Dr. Kamyar Cohanshohet was prescribing excessive narcotics to his patients. After obtaining a report from the Controlled Substance Utilization Review and Evaluation System (CURES) identifying the amount of controlled substances Dr. Cohanshohet prescribed, a Board investigator identified five patients who were possibly prescribed excess doses. The patients refused to release their medical records. Dr. Cohanshohet asserted his patients’ privacy rights and refused to comply with a subpoena to turn them over. The Board then filed a petition seeking an order compelling production of the records. Read more

Hospital liable for damages for inducing physician’s medical group not to schedule him for work without affording peer review rights. Read more