The following is our summary of the Supreme Court’s actions on petitions for review in civil cases from the Court’s conference on Wednesday, February 3, 2016. The summary includes those civil cases in which (1) review has been granted, (2) review has been denied but one or more justices has voted for review, or (3) the Court has ordered depublished an opinion of the Court of Appeal. The Court invited the Department of Managed Health Care to submit an amicus brief in a pending case.
Review Granted
None.
Briefing Requested
Centinela Freeman Emergency Medical Assoc. v. Health Net of California, S218497- Review Granted on May 13, 2014 – Briefing Requested- February 3, 2016
The Court has invited the Department of Managed Health Care (DMHC) to serve and file an amicus curiae brief expressing its views on the following two-part question: In light of the Knox-Keene Health Care Service Plan Act of 1975 (Health & Saf. Code, § 1340 et seq.) and the DMHC’s implementing regulations, does a health care service plan owe a common law tort duty of care to non-contracting emergency service providers, who provide emergency care on a statutorily compelled basis to the health plan’s enrollees, in either (1) making or (2) continuing a delegation of its financial responsibility for payment of the providers’ claims to an individual practice association (IPA)?
The Court of Appeal, Second District, Division Three, held in a published decision, Centinela Freeman Emergency Medical Assoc. v. Health Net of California (2014) 225 Cal.App.4th 237, that an HMO has a duty not to delegate the obligation to reimburse emergency physicians to an IPA it knows or should know will be unable to pay. The Court of Appeal held a cause of action exists for an HMO’s failure to reassume the obligation to reimburse emergency physicians. However, the HMO owes no duty to reimburse a non-emergency radiologist and therefore need not reassume the reimbursement obligation.
Review Denied (with dissenting justices)
None.
Depublished
None.
