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Omlansky v. Save Mart Supermarkets
Plaintiff failed to allege 2009 statutory cap was in effect before his pleading and that it imposed a duty on defendant to incorporate it into its Medi-Cal billings. 		Health Care 3DCA Sep. 4, 2019
Missionary Guadalupanas of the Holy Spirit v. Rouillard
Department's interpretation of basic health care services to include abortions was the only legally tenable interpretation of statute; thus, Administrative Procedure Act rulemaking process was not applicable. 		Health Care 3DCA Aug. 8, 2019
Modification: Rivera v. Kent
The California Department of Health Care Services is not restricted to 45 days when making Medi-Cal eligibility determinations for applicants under Section 15926 under the Welfare & Institutions Code. 		Health Care 1DCA/4 Jul. 25, 2019
Rivera v. Kent
The California Department of Health Care Services is not restricted to 45 days when making Medi-Cal eligibility determinations for applicants under Section 15926 under the Welfare & Institutions Code. 		Health Care 1DCA/4 Jul. 1, 2019
Lomeli v. State Dept. of Health Care Services
Collateral estoppel did not bar government's lien on plaintiff's settlement with tortfeasors; court's approval of settlement was not a decision for purposes of collateral estoppel. 		Health Care 2DCA/8 Jun. 27, 2019
Azar v. Allina Health Services
Because government has not identified lawful excuse for neglecting statutory notice-and-comment obligations, its policy that dramatically reduced payments to hospitals serving low-income patients was vacated. 		Health Care USSC Jun. 4, 2019
Grafilo v. Wolfsohn
A Department of Consumer Affairs subpoena issued during a Medical Board investigation seeking production of patients' medical records must be supported by good cause justifying invasion of patient privacy. 		Health Care 2DCA/1 Apr. 4, 2019
Morris v. California Physicians' Service
The Medical Loss Ratio provision in the Affordable Care Act makes no distinction between in-network and out-of-network providers; thus, district court's dismissal was proper. 		Health Care 9th Mar. 19, 2019
Amended Opinion: U.S. ex rel. Silingo v. Wellpoint
Dismissal of reverse false claim affirmed were appellant fails to defend claim in response to motion to dismiss. 		Health Care 9th Sep. 12, 2018
Santa Rosa Memorial Hospital v. Kent
Medicaid Act precludes private enforcement of 42 U.S.C. Section 1396a(a)(30)(A). 		Health Care 1DCA/3 Aug. 2, 2018
U.S. ex rel. Silingo v. Wellpoint
Dismissal of reverse false claim affirmed were appellant fails to defend claim in response to motion to dismiss. 		Health Care 9th Jul. 10, 2018
American Indian Health v. Kent
State Department of Health Care Services not shielded by sovereign immunity as to mandamus suit over healthcare coverage denials. 		Health Care 3DCA Jun. 21, 2018
Danny P. v. Catholic Health Initiatives
The Parity Act requires that benefits in a health care plan that provides for both medical and mental health or substance use disorder benefits must not impose more restrictions on the mental benefits than it imposes on the medical benefits. 		Health Care 9th Jun. 7, 2018
Alexander v. Scripps Memorial Hospital La Jolla
Hospital Appropriate Care Committee did not violate Probate Code 4731(a) by approving Do Not Resuscitate order in conflict with patient's wishes, as Committee and patient did not meet statutory definition of physician-patient relationship. 		Health Care 4DCA/1 May 16, 2018
Hutcheson v. Eskaton Fountainwood Lodge
On rehearing, panel again finds that attorney-in-fact exceeds authority under power of attorney to admit principal to residential care facility, thus precluding facility from enforcing arbitration agreement contained in admission agreement. 		Health Care 3DCA Nov. 29, 2017
King v. Blue Cross and Blue Shield of Illinois
Plaintiff unsuccessful in arguing that ERISA, as amended by the ACA, banned lifetime benefit maximums for certain retiree-only plans but wins reversal of summary judgment in defendants’ favor. 		Health Care 9th Sep. 11, 2017
Hoag Memorial Hospital Presbyterian v. Price
Secretary of Health and Human Services errs in approving state plan amendment to Medicaid program without first requiring compliance with statute. 		Health Care 9th Aug. 8, 2017
Hutcheson v. Eskaton Fountainwood Lodge
Attorney-in-fact exceeds authority under power of attorney to admit principal to residential care facility, thus precluding facility from enforcing arbitration agreement contained in admission agreement. 		Health Care Jun. 14, 2017
Sanjiv Goel M.D. Inc. v. Regal Medical Group Inc.
Cardiologist unsuccessful in challenging legal standard used by trial court in calculating reasonable value of his medical services. 		Health Care May 25, 2017
Coventry Health Care of Missouri Inc. v. Nevils
State law barring subrogation and reimbursement preempted by Federal Employees Health Benefits Act's preemption provision. 		Health Care Apr. 19, 2017
DB Healthcare v Blue Cross Shield
Health care providers lack statutory standing to file suit under Employee Retirement Income Security Act, as providers are not 'beneficiaries' under Section 502 of Act. 		Health Care Mar. 23, 2017
Swoben v. Unitedhealthcare
Allegation of abuse of Medicare Advantage enrollee reporting system in proposed fourth amended complaint constitutes cognizable legal theory, meriting consideration in district court. 		Health Care Dec. 18, 2016
Centinela Freeman Emergency Medical Associates v. Health Net of California
Health care plans which knowingly assigned enrollees to insolvent individual practice associations owe duty of care to emergency physicians who treated patients, never received payment. 		Health Care Nov. 14, 2016
Humboldt County Adult Protective Services v. Superior Court (Magney)
Attorney fees request under Health Care Decisions Law erroneously denied where county had no reasonable cause to invoke the Law. 		Health Care Oct. 25, 2016
Moran v. Prime Healthcare Management Inc.
'Self-pay patient' sufficiently alleges facts supporting conclusion he has standing to claim amount hospital bills such patients is unconscionable, winning reversal of dismissal. 		Health Care Oct. 5, 2016
Morris Silver M.D. Inc. v. International Longshore and Warehouse Union – Pacific Maritime Association Welfare Plan
Third-party medical provider's contract and quasi-contract claims against ERISA-regulated employee welfare benefit plan not preempted, resulting in reversal of dismissal. 		Health Care Aug. 23, 2016
St. John of God Retirement & Care Center v. Dept. of Health Care Services (Woods)
Care agency required to readmit resident upon first availability of open bed under 42 Fed. Code of Regulations Section 483.12 despite hospital transfer order from contracted physician. 		Health Care Aug. 17, 2016
Roberts v. United Healthcare Services Inc.
Medicare Advantage Program plan enrollee's claims against health plan provider properly dismissed due to federal preemption. 		Health Care Aug. 5, 2016
Zubik v. Burwell
Cases challenging federal regulation requiring petitioners provide contraceptive coverage unless they submit form objecting on religious grounds vacated and remanded in light of parties' supplemental briefing. 		Health Care May 17, 2016
Mission Hospital Regional Medical Center v. Burwell
Hospitals have no power to alter legal obligations with Medicare under their provider agreements by attempting to circumvent continuity of obligations through assets-only purchase. 		Health Care Apr. 12, 2016
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