Justia Health Law Opinion Summaries

The case involves the People of the State of California, represented by the San Diego City Attorney, who filed a complaint against Kaiser Foundation Health Plan, Inc. The complaint alleged that Kaiser violated the unfair competition law (UCL) and false advertising law (FAL) by failing to maintain and update accurate health plan provider directories (PDs) as required by California Health and Safety Code section 1367.27. The People claimed that Kaiser’s inaccuracies in PDs misled consumers and harmed competitors.The Superior Court of San Diego County granted Kaiser’s motion for summary judgment, exercising its discretion to abstain from adjudicating the action. The court reasoned that the legislative framework did not impose an accuracy requirement but rather outlined procedural steps for maintaining PDs. The court concluded that adjudicating the People’s claims would require it to assume regulatory functions and interfere with policy judgments already made by the Legislature and the Department of Managed Health Care (DMHC).The Court of Appeal, Fourth Appellate District, Division One, State of California, reviewed the case and concluded that the trial court abused its discretion by applying the doctrine of judicial abstention. The appellate court found that section 1367.27 sets forth clear mandates for PD accuracy, which the trial court could enforce through its ordinary judicial functions. The appellate court held that the People’s enforcement of these statutory requirements would not interfere with the DMHC’s regulatory functions and that the trial court’s abstention was based on a mistaken view of the law. Consequently, the appellate court reversed the judgment and remanded the matter with directions to deny Kaiser’s motion for summary judgment. View "P. ex rel. Elliott v. Kaiser Foundation Health Plan" on Justia Law

Dignity Health, operating as French Hospital Medical Center, filed a complaint against orthopedic surgeon Troy I. Mounts, M.D., and his corporation to recover an advance paid under their Physician Recruitment Agreement. Mounts filed a cross-complaint alleging retaliation for his complaints about patient care quality, interference with his economic opportunities, and unlawful business practices. Dignity responded with an anti-SLAPP motion to strike the cross-complaint, which the trial court initially denied. The appellate court reversed this decision and remanded the case for further consideration.Upon remand, the trial court concluded that Mounts had not demonstrated a probability of prevailing on his claims. The court found that Dignity's actions were protected by the litigation privilege, the common interest privilege, and were barred by the statute of limitations. Consequently, the court granted Dignity's motion to strike the cross-complaint and ordered Mounts to pay Dignity's attorney fees and costs.The California Court of Appeal, Second Appellate District, Division Six, reviewed the case. The court affirmed the trial court's decision, holding that all of Mounts' claims were based on conduct protected by the litigation privilege (Civil Code § 47, subd. (b)) and the common interest privilege (Civil Code § 47, subd. (c)). The court also found that Dignity's actions were immune under federal law (42 U.S.C. § 11137) and that some claims were barred by the statute of limitations. The appellate court upheld the trial court's orders granting the motion to strike and awarding attorney fees to Dignity. View "Dignity Health v. Mounts" on Justia Law

In a juvenile wardship proceeding, the minor's counsel declared a doubt about the minor's competency to stand trial. Consequently, the juvenile court suspended the proceedings and referred the minor for a competency evaluation. The court's protocol mandated the disclosure of the minor's mental health records to the court-appointed expert for evaluation. The minor objected, citing the psychotherapist-patient privilege under California Evidence Code section 1014. The court overruled the objection and ordered the disclosure, prompting the minor to file a writ petition challenging this decision.The Contra Costa County Superior Court overruled the minor's objection, stating that Welfare and Institutions Code section 709 permits the compelled disclosure of all available records, including mental health records, for competency evaluations. The court also referenced Evidence Code section 1025, which it interpreted as allowing such disclosures in competency proceedings. The minor's request for a stay to seek appellate review was denied, leading to the filing of the writ petition.The California Court of Appeal, First Appellate District, reviewed the case. The court held that Evidence Code section 1016 renders the psychotherapist-patient privilege inapplicable in juvenile competency proceedings once the minor's counsel declares a doubt about the minor's competency. The court reasoned that the issue of the minor's mental or emotional condition is tendered by the minor through their counsel, thus falling under the patient-litigant exception to the privilege. The court denied the minor's writ petition and dissolved the partial stay of the juvenile court's order. View "T.M. v. Superior Court" on Justia Law

Farzam Salami received emergency services at Los Robles Regional Medical Center on three occasions in 2020. He signed a conditions of admission contract agreeing to pay for services rendered, as listed in the hospital's chargemaster. Los Robles billed him for these services, including a significant emergency services fee (EMS fee). Salami paid part of the discounted bill but disputed the EMS fee, claiming it covered general operating costs rather than services actually rendered. He argued that had he known about the EMS fee, he would have sought treatment elsewhere.Salami sued Los Robles in December 2021 for breach of contract and declaratory relief. The trial court sustained Los Robles's demurrer to the first amended complaint (FAC), finding that Salami did not allege he performed his duties under the contract or that Los Robles failed to perform its duties. The court also found that the breach of contract claim could not be cured by amendment. Salami was granted leave to amend to assert claims under the Unfair Competition Law (UCL) and Consumers Legal Remedies Act (CLRA). In his third amended complaint (TAC), Salami alleged that Los Robles failed to disclose the EMS fee adequately.The Court of Appeal of the State of California, Second Appellate District, Division Six, reviewed the case. The court affirmed the trial court's decision, holding that Los Robles had no duty to disclose the EMS fee beyond including it in the chargemaster. The court referenced recent cases, including Moran v. Prime Healthcare Management, Inc., which held that hospitals are not required to provide additional signage or warnings about EMS fees. The court concluded that Los Robles complied with its statutory and regulatory obligations, and Salami's claims under the UCL and CLRA failed as a result. The judgment in favor of Los Robles was affirmed. View "Salami v. Los Robles Regional Medical Center" on Justia Law

The case involves Ryan Owen Frayo, a former employee of A&A Organic Farms Corporation (A&A), who was terminated for refusing to take a COVID-19 test. Frayo sued A&A and its owners, Andrew D. Martin and Aimee M. Raphael-Martin, alleging they violated the Confidentiality of Medical Information Act (CMIA). Frayo claimed that his termination was a result of his refusal to provide a COVID-19 test result, which he argued was equivalent to refusing to sign an authorization for the release of his medical information under the CMIA. He also claimed that A&A used his description of his symptoms, which he considered as medical information, to terminate his employment.The trial court sustained A&A’s demurrer to Frayo’s first amended complaint, finding that Frayo failed to state a claim under the CMIA. The court concluded that Frayo failed to state a claim under section 56.20(b) of the CMIA because the statute prohibits employer discrimination based on an employee’s refusal to sign an authorization to release his medical information, not refusal to take a COVID-19 test. The court also sustained the demurrer to Frayo’s second cause of action under section 56.20(c) because Frayo failed to allege A&A had possession of his medical information, as defined by the statute.The Court of Appeal of the State of California Sixth Appellate District affirmed the trial court's decision. The appellate court agreed with the trial court that Frayo did not state a cognizable CMIA claim under either section 56.20(b) or (c). The court found that Frayo's refusal to take and provide the results of a COVID-19 test was not equivalent to an "employee’s refusal to sign an authorization" under the CMIA. Furthermore, the court concluded that Frayo failed to allege that A&A was in possession of his medical information as defined under the CMIA. Therefore, the court affirmed the judgment of dismissal. View "Frayo v. Martin" on Justia Law

The case involves D.K., a patient diagnosed with an unspecified schizophrenia spectrum and other psychotic disorders, who was found incompetent to stand trial and committed to the Department of State Hospitals (DSH) by the Orange County Superior Court. After D.K.'s transfer to Napa State Hospital, DSH filed a petition for an interim order to compel involuntary medication of D.K. with antipsychotic medication. An administrative law judge (ALJ) conducted an evidentiary hearing and ordered D.K. involuntarily medicated from January 17, 2023, to February 7, 2023. D.K. filed a petition for a writ of administrative mandate with the Napa County Superior Court, challenging the medication order. The superior court denied her petition, concluding D.K. was not entitled to writ review.The Court of Appeal of the State of California First Appellate District Division Three found that D.K.'s appeal was moot because the order had expired and no meaningful relief could be effectuated through review of that order. However, the court exercised its discretion to address D.K.'s appeal of the superior court's finding that the statutory scheme of section 1370 precluded her from filing a writ of administrative mandamus to challenge the medication order. The court concluded that both the significant liberty interests at issue and the language of section 1370 support D.K.'s right to seek writ review. The court reversed the superior court's holding that D.K. was not entitled to writ review. However, it dismissed as moot D.K.'s challenge to the court's finding that substantial evidence supported the involuntary medication order, so it did not remand the case for further proceedings. View "D.K. v. Office of Admin. Hearings" on Justia Law

The case revolves around the death of Skyler A. Womack (Skyler) at Silverscreen Healthcare, Inc., a skilled nursing facility. Skyler's parents, Jonie A. Holland (Holland) and Wayne D. Womack (Wayne), filed a lawsuit against Silverscreen, alleging dependent adult abuse and negligence on behalf of Skyler, as well as their own claim for wrongful death. Silverscreen moved to compel arbitration of the entire complaint based on an arbitration agreement between Skyler and Silverscreen.The Superior Court of Los Angeles County granted Silverscreen’s motion to compel arbitration for the survivor claims but denied the motion for the wrongful death cause of action. The court reasoned that the parents did not have an enforceable arbitration agreement with Silverscreen. The court's decision was heavily influenced by the case Avila v. Southern California Specialty Care, Inc.Silverscreen appealed the decision to the Court of Appeal of the State of California, Second Appellate District. The appellant argued that, according to Ruiz v. Podolsky, the parents are bound by the arbitration agreement signed by Skyler, and therefore, the parents’ wrongful death claim should be subject to arbitration. The appellate court agreed with Silverscreen, stating that Ruiz governs this matter. Consequently, under Ruiz and Code of Civil Procedure section 1295, the parents’ wrongful death claim must go to arbitration along with Skyler’s survivor claims. The court reversed the trial court's decision and remanded the case with directions. View "Holland v. Silverscreen Healthcare, Inc." on Justia Law

The case involves Amber C., the mother of a two-year-old child, Kieran S., who appealed from the juvenile court’s jurisdiction findings and disposition orders after the court sustained a petition by the Los Angeles County Department of Children and Family Services. The petition was filed under Welfare and Institutions Code section 300, subdivision (b), alleging that Amber's substance abuse posed a substantial risk of serious physical harm to Kieran. The Department received a referral in April 2019, stating that the parents used drugs in the child's presence. Amber tested positive for amphetamine, methamphetamine, and morphine. Despite her positive test results, Amber denied using methamphetamine and claimed she did not use any drugs while with Kieran. After failing to cooperate with welfare checks and evading the Department, Amber absconded with Kieran.The juvenile court sustained counts under section 300, subdivision (b), alleging Amber abused substances, failed to protect Kieran from Victor’s mental and emotional issues, and absconded with Kieran. At the disposition hearing, the juvenile court declared Kieran a dependent child of the court, removed him from his parents, ordered Amber to attend a drug treatment program, and ordered reunification services. Amber appealed from the jurisdiction findings and disposition orders, arguing that there was no evidence she was under the influence of drugs when Kieran was detained and that there was no evidence of neglect or risk of harm to Kieran in her care.The Supreme Court granted Amber’s petition for review and transferred the case back to the Court of Appeal with directions to vacate its prior decision and reconsider Amber’s appeal in light of In re N.R., which held that substance abuse is not prima facie evidence of a parent’s inability to provide regular care to a child of tender years. The Court of Appeal found that substantial evidence supported the juvenile court’s finding Amber’s drug abuse created a substantial risk of physical harm to Kieran and affirmed the juvenile court’s jurisdiction findings and disposition orders. View "In re Kieran S." on Justia Law

Dr. Ryan Kime, an emergency medicine physician, applied for privileges in the emergency department of two hospitals owned by Dignity Health, Inc. (Dignity) while he was under disciplinary proceedings by the Medical Board of California. The proceedings resulted in a public reprimand. Dignity stopped processing Kime’s application a few days after the reprimand took effect. Kime sued Dignity for injunctive relief and damages, alleging that Dignity violated his common law and statutory rights by denying his application without offering him a hearing. Dignity moved for summary judgment, arguing that it had a policy not to consider applicants with disciplinary histories for emergency department privileges, and that no hearing is required when privileges are denied due to such a policy. The trial court granted Dignity’s motion for summary judgment and denied Kime’s motion for summary adjudication.The Court of Appeal of the State of California First Appellate District affirmed the trial court's decision. The court found that Dignity's policy of not considering applicants with disciplinary histories for emergency department privileges was a quasi-legislative decision, which did not require a hearing under the common law right to fair procedure. The court also found that Dignity's decision to deny Kime's application did not require a hearing under the statutory right set forth in the Business and Professions Code, as the decision was not made by a peer review body and did not require the filing of a report under section 805 of the Code. The court concluded that Kime had no right to a hearing under either the common law or statutory law. View "Kime v. Dignity Health, Inc." on Justia Law

The case involves Christine Matlock Dougherty, who sued U.S. Behavioral Health Plan, California (USB) for claims related to her son's healthcare. Dougherty's son, Ryan, was enrolled in a UnitedHealthcare HMO health plan, which Dougherty had access to through her employer. Ryan admitted himself into a residential treatment facility for severe drug addiction, but USB denied coverage for his stay after three days, arguing that he could be treated at home. Ryan fatally overdosed shortly after his discharge from the facility. Dougherty then sued USB, claiming that its wrongful denial of coverage for Ryan's treatment caused his death. USB petitioned to compel arbitration of her claims, but the trial court denied the petition, stating that USB's arbitration agreement was not enforceable because it did not comply with the disclosure requirements imposed by Health & Safety Code section 1363.1.The trial court denied USB's petition to compel arbitration on the grounds that the arbitration agreement did not comply with the disclosure requirements of Health & Safety Code section 1363.1. The court found that there were two separate contracts, one between Dougherty and UnitedHealthcare, and another between Dougherty and USB. The court ruled that the arbitration agreement in the supplement, which governed Dougherty's claims against USB, did not comply with section 1363.1's disclosure requirements.The Court of Appeal of the State of California Fourth Appellate District Division Two reversed the trial court's decision. The appellate court concluded that USB forfeited its argument that the issue of whether the arbitration agreement was valid under the disclosure requirements of section 1363.1 was delegated to the arbitrator. However, the court agreed with USB that the trial court erroneously denied USB’s petition because USB complied with section 1363.1. The court found that the only "health care service plan" at issue that "includes terms that require binding arbitration" is Dougherty’s plan with UnitedHealthcare, which includes both the EOC and the supplement as components of the plan. Therefore, the court concluded that there was no section 1363.1 violation and reversed the trial court's order denying the petition to compel arbitration. View "Dougherty v. U.S. Behavioral Health Plan" on Justia Law