CENTINELA FREEMAN EMERGENCY MEDICAL ASSOCIATES v. HEALTH NET OF CALIFORNIA, INC.

No. B238867.

223 Cal.App.4th 1366 (2014)

168 Cal. Rptr. 3d 91

CENTINELA FREEMAN EMERGENCY MEDICAL ASSOCIATES et al., Plaintiffs and Appellants, v. HEALTH NET OF CALIFORNIA, INC., et al., Defendants and Respondents.

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

February 19, 2014.


Attorney(s) appearing for the Case

Michelman & Robinson, Andrew H. Selesnick , Robin James and Jason O. Cheuk for Plaintiffs and Appellants.

Francisco J. Silva , Long X. Do and Michelle Rubalcava for California Medical Association, California Hospital Association, California Orthopaedic Association, California Radiological Society and California Society of Pathologists as Amici Curiae on behalf of Plaintiffs and Appellants.

Astrid G. Meghrigian for California Chapter of the American College of Emergency Physicians as Amicus Curiae on behalf of Plaintiffs and Appellants.

Reed Smith>, Margaret M. Grignon , Kurt C. Peterson , Kenneth N. Smersfelt and Zareh A. Jaltorossian for Defendant and Respondent Blue Cross of California doing business as Anthem Blue Cross.

Crowell & Moring, William A. Helvestine , Ethan P. Schulman and Damian D. Capozzola for Defendant and Respondent Health Net of California, Inc.

Crowell & Moring and Jennifer S. Romano for Defendant and Respondent Pacificare of California doing business as Secure Horizons Health Plan of America.

Manatt, Phelps & Phillips, Gregory N. Pimstone , Joanna S. McCallum and Jeffrey J. Maurer for Defendant and Respondent California Physicians' Service doing business as Blue Shield of California.

Heranandez Schaedel & Associates, Gonzales Saggio & Harlan, Don A. Hernandez and Jamie L. Lopez for SCAN Health Plan.

Gibson, Dunn & Crutcher, Kirk A. Patrick and Heather L. Richardson for Defendant and Respondent Aetna Health of California.

DLA Piper, William P. Donovan, Jr. , and Matthew D. Caplan for Defendant and Respondent Cigna HealthCare of California, Inc.

Barger & Wolen, John M. LeBlanc and Sandra I. Weishart for California Association of Health Plans as Amicus Curiae on behalf of Defendants and Respondents.


OPINION

CROSKEY, J.

The law imposes a duty on emergency room physicians to treat patients regardless of their ability to pay. When those patients are enrollees in health care service plans (HMO's),1 the law imposes an obligation on the HMO's to reimburse the physicians for emergency treatment provided to the enrollees, even when the physicians were not under contract to the HMO's. HMO's sometimes delegate...

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