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Name Category Published
U.S. v. Holden
Health care fraud (in violation of 18 U.S.C. Section 1347) is continuing offense; government may charge a single health care fraud scheme even when several acts in furtherance of scheme fall outside statute of limitations. 		Health Care Dec. 4, 2015
UFCW & Employers Benefit Trust v. Sutter Health
Third-party payor cannot be compelled to arbitrate dispute pursuant to agreement signed by health care provider and contracting agent. 		Health Care Oct. 29, 2015
Marquez v. Dept. of Health Care Services
Notice and hearing not required whenever state agencies changes a Medi-Cal beneficiary's 'other health coverage' code. 		Health Care Oct. 1, 2015
Marquez v. Dept. of Health Care Services
Notice and hearing not required whenever state agencies changes a Medi-Cal beneficiary's 'other health coverage' code. 		Health Care Sep. 4, 2015
Nosal-Tabor v. Sharp Chula Vista Medical Ctr.
Hospital not entitled to summary judgment where reasonable juror could find that nurse was wrongfully terminated for refusing to follow legally deficient procedures. 		Health Care Aug. 31, 2015
King v. Burwell
Affordable Care Act tax credits are available to individuals in all States, including States that have a Federal Exchange, ensuring continued access for millions to affordable health insurance. 		Health Care Jun. 25, 2015
K.W. v. Armstrong
Idaho may not implement reduced budgets for Developmental Disabilities Waiver program participants absent adequate notice for reductions. 		Health Care Jun. 7, 2015
Aguilera v. Loma Linda Univ. Med. Center
Future health care expenses should be excluded when calculating reimbursement by State Department of Health Care Services but Department must present sufficient evidence to support the exclusion. 		Health Care Apr. 2, 2015
Herting v. California Dept. of Health Care Services
DHCS may seek reimbursement from special needs trust for medical expenses paid on behalf of young beneficiary. 		Health Care Mar. 30, 2015
Plott Nursing Home v. Burwell
California skilled nursing facility avoids penalty for violating UTI standards, but remains liable for violating bedsore standards. 		Health Care Mar. 3, 2015
Lemaire v. Covenant Care California
State ‘Patients Rights’ statute limits recovery to $500, not $500 ‘per violation.’ 		Health Care Feb. 24, 2015
Saint Alphonsus Medical Center – Nampa Inc. v. St. Luke’s Health System Ltd.
Hospital merger that may result in increased efficiencies, but not increased competition, violates Clayton Act. 		Health Care Feb. 11, 2015
Sarun v. Dignity Health
Hospital's allegedly inflated fees enough to provide plaintiff standing. 		Health Care Jan. 14, 2015
Sarun v. Dignity Health
Hospital's allegedly inflated fees enough to provide plaintiff standing. 		Health Care Jan. 7, 2015
Hale v. Sharp Healthcare
Healthcare provider successfully defeats class certification of lawsuit alleging unfair billing of uninsured patients because class was not readily ascertainable. 		Health Care Dec. 7, 2014
Spinedex Physical Therapy USA Inc. v. United Healthcare of Arizona Inc.
Physical therapy clinic has standing to sue health plans and claims administrator for improper denial of benefits, as assignee of patients’ claims. 		Health Care Nov. 5, 2014
Hoang v. California State Board of Pharmacy
State Board of Pharmacy properly revokes pharmacist's license due to covert use of other pharmacy's billing authority for filling Medi-Cal patients’ prescriptions. 		Health Care Oct. 9, 2014
Norasingh v. Lightbourne
Disabled woman who suffered from psychogenic seizures is entitled to protective supervision benefits under In-Home Supportive Services Program. 		Health Care Sep. 9, 2014
Dameron Hospital Association v. AAA Northern California, Nevada, and Utah Insurance Exchange
Emergency room operator may not collect difference between customary charges and negotiated rates from third party tortfeasors under contract with patients’ insurer. 		Health Care Sep. 4, 2014
Coons v. Lew
Doctor may not challenge Patient Protection and Affordable Care Act’s establishment of Independent Payment Advisory Board based on allegations of possible future injury. 		Health Care Sep. 2, 2014
Dameron Hospital Association v. AAA Northern California
Emergency room operator may not collect difference between customary charges and negotiated rates from third party tortfeasors under contract with patients’ insurer. 		Health Care Aug. 25, 2014
Pacific Shores Hospital v. United Behavioral Health
Health care plan improperly denies employee, who suffered from severe anorexia and was suicidal, more than three weeks of residential treatment coverage. 		Health Care Aug. 20, 2014
Coons v. Lew
Doctor may not challenge Patient Protection and Affordable Care Act’s establishment of Independent Payment Advisory Board based on allegations of possible future injury. 		Health Care Aug. 7, 2014
Orthopedic Specialists of Southern California v. California Public Employees' Retirement System
Out-of-network medical provider is not entitled customary and usual rate for nonemergency medical services where insurer paid only small portion of amount charged. 		Health Care Jul. 31, 2014
Dameron Hospital Association v. AAA Northern California
Emergency room operator may not collect difference between customary charges and negotiated rates from third party tortfeasors under contract with patients’ insurer. 		Health Care Jul. 29, 2014
State of California v. Superior Court (Bristol-Myers Squibb Co.)
Drug company only needs to make claims that are ‘in some manner deceitful’ to trigger possible civil penalties for bribing physicians to prescribe its drugs. 		Health Care Jul. 27, 2014
Gonzalez v. Planned Parenthood of Los Angeles
Planned Parenthood does not knowingly and falsely overbill Medi-Cal for contraceptives supplied to low-income individuals when charging ‘usual and customary rates.’ 		Health Care Jul. 22, 2014
Sutter Health v. Superior Court (Atkins)
Patients may not sue health care provider following theft of computer containing their medical records when no unauthorized person actually viewed records. 		Health Care Jul. 21, 2014
County of Colusa v. Douglas
State of California, rather than counties, must pay for ancillary outpatient services for Medi-Cal beneficiaries with mental diseases who are not covered by federal law. 		Health Care Jul. 20, 2014
County of Colusa v. Douglas
State of California, rather than counties, must pay for ancillary outpatient services for Medi-Cal beneficiaries with mental diseases who are not covered by federal law. 		Health Care Jul. 13, 2014
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