Business Law Health Law Committee

ERISA preempts out-of-network provider’s state-law reimbursement claims against health plan administrator Read more

Hospitals must count “bed holds” in subacute section as “patient days” when determining Medi-Cal reimbursement. Read more

Medical screening business can be liable (as an employer’s agent) for FEHA violations. Read more

Hospital’s failure to provide pretreatment disclosure of emergency medical evaluation fees beyond what is required by statute is not actionable. Read more

Health plan’s duty to transport conservatee to psychiatric facility for assessment and evaluation is triggered by an authorized professional’s custodial determination, not by the conservator’s demand. Read more

Personal representative could not compel production of a minor’s medical records without proving they were withheld in bad faith. Read more

State-law tort and statutory claims against health insurer are expressly preempted by Medicare Part C.  Read more

CMA’s standing to sue health insurer under the UCL based on diverting resources to oppose a business practice presents a triable issue. Read more

Public health care service plans are not immune from provider reimbursement actions under the Knox-Keene Act. Read more

Family members placed Gorgi Talevski in a county-owned nursing home in Indiana when his dementia progressed to the point they could no longer care for him. Read more