Appellate Updates

Vilches v. Leao (July 28, 2023, A163638) __ Cal.App.5th __ [2023 WL 4839283]

Frank Vilches, the guardian of his minor daughter, hired therapist Michelle Leao to treat his daughter. Vilches later requested copies of his daughter’s therapy records. 

Family Health Centers of San Diego v. State Dept. of Health Care Services (July 24, 2023, S270326) __ Cal.5th __ [2023 WL 4697232].  

Federally qualified health centers (FQHCs) receive federal funding to provide basic health care to underserved communities regardless of patients’ ability to pay.

Quishenberry v. UnitedHealthcare, Inc. (July 13, 2023) __ Cal.5th __ [2023 WL 4511572]

Larry Quishenberry’s father was insured under Medicare Part C, a federal program that subsidizes the cost of private healthcare plans for beneficiaries.

California Medical Association v. Aetna Health of California Inc. (July 17, 2023) __ Cal.5th __ [2023 WL 4553703]

Insurer Aetna Health of California implemented a policy that threatened to terminate in-network providers’ contracts for referring patients to out-of-network providers.

County of Santa Clara v. Superior Court (July 10, 2023) __ Cal.5th __ [2023 WL 4414084]

As required by state and federal law, Doctors Medical Center of Modesto, Inc., and Doctors Hospital of Manteca, Inc., provided emergency medical care to three individuals enrolled in a health care service plan operated by the County of Santa Clara. The hospitals had no contract with the County governing rates payable for emergency services rendered to plan members...

Williams v. West Coast Hospitals, Inc. (Dec. 22, 2022, H049177) __ Cal.App.5th __ [2022 WL 17881773]

Ann Williams was admitted to a West Coast Hospital center to recover from hip surgery. West Coast discharged her to an assisted living facility where she died five days later. Williams’ son (and other family members) sued West Coast for elder abuse and wrongful death, alleging that its failure to nourish and hydrate Williams cause fatal renal failure. The trial court granted West Coast’s motion to compel arbitration, which stayed the litigation, but West Coast then failed to pay its arbitration filing fee on time. Plaintiffs moved for an order vacating the litigation stay based on their election to withdraw from arbitration under Code of Civil Procedure sections 1281.97 and 1281.98 (because West Coast had not timely paid arbitration fees). Although West Coast belatedly paid its fees, the trial court granted the motion. West Coast appealed.

Hodges v. Cedars-Sinai Medical Center (2023) 91 Cal.App.5th 894

Deanna Hodges worked for Cedars-Sinai Medical Center in an administrative role with no patient care responsibilities. Cedars terminated her employment because she refused to get a flu vaccine.  Cedars’s flu vaccine policy made exceptions for employees who established “a valid medical or religious exemption.” Employees who declined the vaccine “based on medical contraindication, per CDC guidelines” were required to submit an exemption request completed by their physician.  Hodges’s doctor wrote a note recommending an exemption based on her history of cancer and general allergies.

Health & Hospital Corp. v. Talevski, 599 U.S. __, 2023 WL 3872515 (June 8, 2023)

Family members placed Gorgi Talevski in a county-owned nursing home in Indiana when his dementia progressed to the point they could no longer care for him. His condition quickly deteriorated. The family attributed his decline to the nursing home’s use of powerful psychotropic medications. When the nursing home began transferring Talevski to a distant psychiatric hospital for days at a time, the family complained to the state health department.

Chaudhry v. Aragon, 68 F.4th 1161 (9th Cir. May 23, 2023)

A patient suffered hypoxic brain injury during open heart surgery at a private hospital. The hospital, California Department of Public Health (CDPH), and Centers for Medicare and Medicaid Services conducted separate investigations and found that the lead surgeon, Dr. Pervaiz Chaudhry, left the operating room before the patient was stable and his chest was closed.

Dubin v. United States, 599 U.S. __, 2023 WL 3872518 (June 8, 2023)

David Dubin overbilled Medicaid $338 by overstating the qualifications of employees who performed psychological testing. A jury convicted him of healthcare fraud under 18 U.S.C. § 1347 and aggravated identity theft under § 1028A. The Government sought a 2-year prison sentence enhancement for aggravated identity theft under § 1028A(a)(1).