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LIFE CARE CENTERS OF AMERICA v. CalOPTIMA

No. G034479.

35 Cal.Rptr.3d 387 (2005)

133 Cal.App.4th 1169

LIFE CARE CENTERS OF AMERICA, Plaintiff and Respondent, v. CalOPTIMA, Defendant and Appellant.

Court of Appeals of California, Fourth District, Division Three.

October 31, 2005.

Attorney(s) appearing for the Case

Foley & Lardner, James N. Godes, Susanne C. Washington and Kenneth S. Klein, San Diego, for Defendant and Appellant.

Sanders, Collins & Rehaste, Rita A. Rehaste, Roberta L. Cutsinger and Brian E. Edwards, Orange, for Plaintiff and Respondent.

Hooper, Lundy & Bookman, Mark E. Reagan, Scott J. Kiepen, San Francisco, and Felicia Y. Sze, for the California Association of Health Facilities as Amicus Curiae on behalf of Plaintiff and Respondent.

OPINION

ARONSON, J.

Defendant CalOptima is a county organized health system (COHS) providing services to Medi-Cal beneficiaries through contracts with various health care providers. Under its prior authorization policy, CalOptima requires long-term care providers to submit treatment authorization requests (TAR's)1 within 21 days of the patient's admission. This case arose out of six TAR's submitted by plaintiff Life Care Centers...

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