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Daily appellate reports
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Name Category Published
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
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
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