Articles Posted in California Courts of Appeal

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This case turned on whether an attorney-in-fact who admitted her principal to a residential care facility for the elderly made a “health care” decision. If she did, as the trial court found, she acted outside the scope of her authority under the power of attorney, and the admission agreement she signed, and its arbitration clause this appeal sought to enforce, were void. On these facts the Court of Appeal concluded the decision was health care decision, and the attorney-in-fact who admitted her, acting under the PAL, was not authorized to make those kinds of decisions on behalf of the principal. As a result of this conclusion, the Court affirmed the trial court’s denial of a motion by the residential care facility to compel arbitration. Because the attorney-in-fact acting under the PAL did not have authority to admit the principal to the residential care facility for the elderly, her execution of the admission agreement and its arbitration clause were void. View "Hutcheson v. Eskaton Fountainwood Lodge" on Justia Law

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Pacific Bay treated an individual who was a subscriber to a Blue Shield health plan. It submitted invoices to Blue Shield for payment for the services rendered to the subscriber. Pacific Bay contends it was underpaid and brought suit against Blue Shield to recover the additional amount it claimed to be owed. The court sustained Blue Shield's demurrer to the first amended complaint (FAC) without leave to amend, finding that Pacific Bay had not shown that it was entitled to any payment from Blue Shield. As an out-of-network, nonemergency service provider, Pacific Bay was entitled to payment for treating Blue Shield's subscriber under the terms of the applicable evidence of coverage (EOC). Pacific Bay did not allege Blue Shield paid it improperly under the EOC, nor did it argue that it could allege additional facts to support such a claim. Pacific Bay claimed it was underpaid. Against this backdrop, Pacific Bay's other allegations did not give rise to any valid cause of action. View "Pacific Bay Recovery v. Cal. Physicians' Services" on Justia Law

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At issue was whether the trial court employed the correct legal standard in determining the reasonable value of appellant's emergency treatment of four patients as an interventional cardiologist. The Court of Appeal agreed with the parties that the court in Children's Hospital Central California v. Blue Cross of California, (2014) 226 Cal.App.4th 1260, correctly applied the governing standard. The Court of Appeal declined to adopt appellant's narrow reading of the case and, instead, held that Children's Hospital supports the decision that the trial court made here to consider a variety of evidence to determine the "reasonable market value" of the services that appellant provided under quantum meruit principles. Accordingly, the court affirmed the judgment of the trial court. View "Sanjiv Goel, M.D., Inc. v. Regal Medical Group" on Justia Law

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Psychotherapist-patient privilege does not protect subpoenaed records from disclosure to the Department of Consumer Affairs, because Business and Professions Code section 2225, a statute enacted after codification of the privilege, permits disclosure of records that the privilege would otherwise shelter when the Department and the Board are investigating potential improper prescribing of controlled substances by a psychiatrist. Furthermore, a psychiatric patient's constitutional right to privacy requires the Department to demonstrate a subpoena for the patient's records is supported by a compelling interest and that the information demanded is "relevant and material" to the particular investigation being conducted. In this case, the State had a compelling interest in investigating excessive or otherwise improper prescribing of controlled substances, and petitioner's declaration established most of the records demanded by the subpoena were relevant and material to that investigation. However, further narrowing of the Department's subpoenas was required to comport with the weighty privacy interests at stake. Accordingly, the Court of Appeals granted the petition in part and vacated in part. View "Cross v. Superior Court" on Justia Law