Facts

Plaintiff Long Beach Memorial Center operates hospitals in the Long Beach area. Plaintiff brought an action against Los Angeles County Department of Health Services alleging that in 2016 and 2018, DHS underpaid/denied benefits for medical services provided to patients of a County administered, sponsored or financial health plan.

PLAINTIFF'S CONTENTIONS: Plaintiff contended that defendants breached the implied in fact contract when defendants underpaid/denied benefits for medical services provided to patients of a county administered, sponsored, or financial health plan. Plaintiff contended that defendants breached the covenant of good faith and fair dealing when defendants underpaid/denied benefits for the medical services provided to patients of a county administered, sponsored, or financial health plan. Plaintiff contended it is entitled to repayment for medical services rendered.

DEFENDANT'S CONTENTIONS: Defendant denied all of the contentions. Defendant contended that it denied 14 claims because it was determined by DHS medical experts that plaintiff either did not notify DHS within 24 hours of the patients' admittance to the hospital and/or the patients did not meet the criteria for the level of care provided. Defendant also contended that the patients could have been transferred to an in-network hospital or discharged earlier.

Result

The case settled for $45,000.