Business Law Health Law Committee

Plaintiff Charles Logan executed an Advanced Directive (Prob. Code, §§ 4600–4805) appointing his nephew, Mark Harrod, as his health care agent. Read more

Plaintiff Michael Franklin’s primary care physician referred him to Dr. John Park, a neurosurgeon, for herniated disc treatment. Franklin viewed webpages indicating that Dr. Park was associated with Cottage Hospital before seeing him for treatment. Read more

Noncontracted providers of nonemergency services to Medi-Cal managed care plan enrollees are not entitled to reimbursement exceeding Medi-Cal fee schedule rates. Read more

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. Read more

Ostensible agency theory fails where patient’s personal physician performs surgery at a hospital. Read more

Medicare’s low-income patient hospital reimbursement adjustment is based on individuals “entitled” to Part A benefits, even if Medicare doesn’t pay for their treatment. Read more

California’s In-Home Support Services (IHSS) program uses Medicaid funding to provide assistance with daily activities to elderly and disabled beneficiaries, often by family members. Read more

HHS may not vary Medicare prescription drug reimbursement rates by hospital group unless it surveys hospital acquisition costs. Read more

Medicare’s Secondary Payer statute, 42 U.S.C. § 1395y(b), makes Medicare a “secondary” payer for certain medical services when an individual’s insurance plan also provides coverage. Read more

State-law formula for allocating tort settlement funds between past and future medical expenses not preempted by the Medicaid Act. Read more