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PACIFIC SHORES HOSP. v. UNITED BEHAVIORAL HEALTH

No. 12-55210.

764 F.3d 1030 (2014)

PACIFIC SHORES HOSPITAL, Assignee, Plaintiff-Appellant, v. UNITED BEHAVIORAL HEALTH; Wells Fargo & Company Health Plan, Defendants-Appellees.

United States Court of Appeals, Ninth Circuit.

Filed August 20, 2014.

Attorney(s) appearing for the Case

Elizabeth K. Green , Lisa S. Kantor (argued), and Peter S. Sessions , Kantor & Kantor LLP, Northridge, California, for Plaintiff-Appellant.

Robert Claude Bohner , Douglas J. Collodel (argued), and David Michael Humiston , Sedgwick LLP, Los Angeles, California, for Defendants-Appellees.

M. Patricia Smith , Solicitor of Labor, Timothy D. Hauser , Associate Solicitor for Plan Benefits Security Division, Elizabeth Hopkins , Counsel for Appellate and Special Litigation, and Candyce Phoenix (argued), Trial Attorney, United States Department of Labor, Washington, D.C., for Amicus Curiae Secretary of Labor.

Before: WILLIAM A. FLETCHER, MILAN D. SMITH, JR., and PAUL J. WATFORD, Circuit Judges.

OPINION

W. FLETCHER, Circuit Judge:

An employee of Wells Fargo, whom we will call Jane Jones, was covered under the Wells Fargo & Company Health Plan (the "Plan"), governed by the Employee Retirement Income Security Act of 1974 ("ERISA"). United Behavioral Health ("UBH") is a third-party claims administrator of the Plan. Jones was admitted to Pacific Shores Hospital ("PSH") for acute inpatient treatment for severe anorexia nervosa. UBH refused to pay...

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