Articles Posted in Health Law

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If a patient who receives emergency medical services is an enrollee in a health care service plan, the plan is required to reimburse the emergency service provider for essential emergency medical services and care. Plans are statutorily permitted to delegate this financial responsibility to their contracting medical providers. Here the defendants - health care service plans - delegated their emergency services financial responsibility to their contractor medical providers, three individual practice associations (“IPAs”). The IPAs failed to reimburse the plaintiff noncontracting service providers for the emergency care that they provided to enrollees of the defendant health plans. When the IPAs went out of business, the plaintiff providers brought actions seeking reimbursement from the defendants. The Supreme Court held (1) a health care service plan may be liable to noncontracting emergency service providers for negligently delegating its financial responsibility to an IPA or other contracting medical provider group that it knew or should have known would not be able to pay for emergency service and care provided to the health plan’s enrollees; and (2) a health care service plan has a narrow continuing common law tort duty to protect noncontracting emergency service providers once it makes an initial delegation of its financial responsibility. View "Centinela Freeman Emergency Medical Associates v. Health Net of California" on Justia Law

Posted in: Contracts, Health Law

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In 1998, Defendant pleaded not guilty by reason of insanity (NGI) to one count of lewd and lascivious conduct with a child and was committed to Napa State Hospital. In 2011, the Santa Clara County District Attorney petitioned to extend Defendant’s commitment a fourth time. Defendant opposed an extension of his commitment, and defense counsel requested a bench trial. After a bench trial, the trial court entered an order extending Defendant’s commitment. The Supreme Court reversed, holding (1) the trial court must advise an NGI defendant personally of his or her right to a jury trial and, before holding a bench trial, must obtain a personal waiver of that right from the defendant unless the court finds that the defendant lacks the capacity to make a knowing and voluntary waiver, in which case defense counsel controls the waiver decision; and (2) the trial court in this case erred in conducting a bench trial that extended Defendant’s commitment because the court did not advise Defendant of his right to a jury trial, did not obtain Defendant’s personal waiver of that right, and did not find substantial evidence that Defendant lacked the capacity to make a knowing and voluntary waiver. Remanded. View "People v. Tran" on Justia Law

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In 2006, Defendant was declared a mentally disordered offender and committed to Atascadero State Hospital as a condition of parole. In 2011, the Santa Clara County District Attorney filed a third petition to extend Defendant’s commitment. Defendant opposed an extension of his commitment, and defense counsel requested a bench trial. After a bench trial, the trial court extended Defendant’s commitment. Defendant appealed, arguing that the trial court committed prejudicial error by failing to advise him of the right to a jury trial and by conducting a bench trial without first obtaining his personal waiver of that right. The Supreme Court reversed, holding that the trial court erred in conducting a bench trial that extended Defendant’s commitment, as (1) the statutory scheme that governs mentally disordered offender commitment proceedings expressly provides for advisement and waiver of the right to a jury trial; and (2) the trial court did not advise Defendant of his right to a jury trial in this case, did not obtain Defendant’s personal waiver of that right, and did not find that Defendant lacked the capacity to make a knowing and voluntary waiver. Remanded. View "People v. Blackburn" on Justia Law

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The Center for Investigative Reporting filed a Public Records Act request for copies of all citations issued by the Department of Public Health (DPH) to the long-term health care facilities the Center was investigating. The DPH disclosed heavily redacted copies of the citations it had issued to the facilities, asserting that Cal. Welf. & Inst. Code 5328 obligated it not to release confidential information obtained in the course of providing services to mentally ill and developmentally disabled individuals. The trial court determined that the Long-Term Care, Health, Safety, and Security Act's mandate that DPH citations be made public with minimal redaction trumped section 5328’s confidentiality provisions. The Court of Appeal vacated the judgment of the trial court and ordered DPH to disclose such information as the Court of Appeal deemed consistent with the common purpose of both statutes while permitting DPH to redact such information as the court deemed inconsistent with that common purpose. The Supreme Court reversed and remanded with instructions for the Court of Appeal to deny the petition, holding that DPH citations issued under the Act are public records and must be disclosed to the Center subject only to the specific redactions mandated by the Act. View "State Dep’t of Pub. Health v. Superior Court" on Justia Law

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Plaintiff filed suit against defendants for negligence and premises liability, as well as battery. At issue was whether patients suffering from Alzheimer's disease are liable for injuries they inflict on health care workers hired to care for them at home. California and other jurisdictions have established the rule that Alzheimer's patients are not liable for injuries to caregivers in institutional settings. The court concluded that the same rule applies to in-home caregivers who, like their institutional counterparts, are employed specifically to assist these disabled persons; it is a settled principle that those hired to manage a hazardous condition may not sue their clients for injuries caused by the very risks they were retained to confront; the court's opinion is consistent with the strong public policy against confining the disabled in institutions; and the court encouraged the Legislature to focus its attention on the problems associated with Alzheimer's caregiving. View "Gregory v. Cott" on Justia Law

Posted in: Health Law, Injury Law

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Plaintiff, a hospital staff physician, claimed the hospital’s decision to terminate his staff privileges was an act of retaliation for his reports of substandard performance by hospital nurses and thus a violation of Cal. Health & Safety Code 1278.5. Defendants moved to dismiss on grounds that Plaintiff could not bring a civil suit under section 1278.5 unless he first succeeded by mandamus in overturning the hospital’s action. The appellate court held that Plaintiff could pursue his claims based on section 1278.5 even though he had not previously sought and obtained a mandamus judgment against the hospital’s decision. The Supreme Court affirmed, holding that a physician’s claim that a hospital decision to restrict or terminate his or her staff privileges was an act of retaliation for his or her whistleblowing in furtherance of patient care and safety need not seek and obtain a mandamus petition to overturn the decision before filing a civil action under section 1278.5. View "Fahlen v. Sutter Cent. Valley Hosps." on Justia Law

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The City of Riverside declared, by zoning ordinances, that medical marijuana dispensaries were prohibited within the City. Invoking these provisions, the City brought a nuisance action against a facility operated by Defendants. The trial court issued a preliminary injunction against the distribution of marijuana from the facility. The court of appeal affirmed. Defendants appealed, arguing that the Compassionate Use Act (CUA) and the Medical Marijuana Program (MMP) preempted the City's total ban on facilities that cultivated and distributed medical marijuana in compliance with the CUA and MMP. The Supreme Court affirmed, holding that California's medical marijuana statutes do not expressly or impliedly preempt the authority of California cities and counties, under their traditional land use and police powers, to allow, restrict, limit, or entirely exclude facilities that distribute medical marijuana, and to enforce such policies by nuisance actions. View "City of Riverside v. Inland Empire Patients Health & Wellness Ctr., Inc." on Justia Law

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Six days after his birth, Plaintiff suffered irreversible brain damage. Through his mother as guardian ad litem, Plaintiff sued his pediatrician and the hospital in which he was born. Before trial, Plaintiff and the pediatrician agreed to settlement of $1 million. At a jury trial, Plaintiff was awarded both economic and noneconomic damages. The jury found the pediatrician was fifty-five percent at fault and the hospital forty percent at fault. The court of appeal reversed the portion of the trial court's judgment awarding Plaintiff economic damages against the hospital after applying the common law "release rule," under which Plaintiff's settlement with the pediatrician also released the nonsettling hospital from liability for Plaintiff's economic damages. The Supreme Court reversed, holding (1) the common law release rule is no longer to be followed in California; and (2) therefore, the defendant hospital remained jointly and severally liable for Plaintiff's economic damages. View "Leung v. Verdugo Hills Hosp." on Justia Law

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This case arose when plaintiff was seriously injured in an automobile accident negligently caused by a driver for defendant. At issue was whether an injured person could recover from the tortfeasor, as economic damages for past medical expenses, the undiscounted sum stated in the medical care provider's bill but never paid by or on behalf of the injured person. The court held that the collateral source rule, which precluded deduction of compensation the plaintiff had received from sources independent of the tortfeasor from damages the plaintiff "would otherwise collect from the tortfeasor" ensured that plaintiff here could recover in damages the amounts her insurer paid for her medical care. The rule, however, had no bearing on amounts that were included in a provider's bill but for which the plaintiff never incurred liability because the provider, by prior agreement, accepted a lesser amount as full payment. Such sums were not damages the plaintiff would otherwise have collected from the defendant and were neither paid to the providers on the plaintiff's behalf nor paid to the plaintiff in indemnity of his or her expenses. Therefore, because they did not represent an economic loss for the plaintiff, they were not recoverable in the first instance. The collateral source rule precluded certain deductions against otherwise recoverable damages, but did not expand the scope of economic damages to include expenses the plaintiff never incurred. View "Howell v. Hamilton Meats" on Justia Law

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In this case, the court addressed the remedies available to a patient when a debt collector, acting on behalf of a medical professional, was asserted to have illegally disclosed confidential patient information to various consumer reporting agencies in the course of a dispute over an alleged medical debt. At issue was whether all state law claims arising from the furnishing of information to consumer reporting agencies were preempted by the Fair Credit Reporting Act ("FCRA"), 15 U.S.C. 1681t(b)(1)(F). The court concluded that, because of the dual state and federal responses to the protection of an individual's privacy and accuracy interests, when the interests overlap, as in this case, the question of what remedies were available was a federalism problem. The court subsequently held that Congress did not intend for the state remedies to be preempted. Accordingly, the court reversed and remanded for further proceedings. View "Brown v. Mortensen" on Justia Law