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New Cases of Interest - December 30, 2016
Centinela Freeman Emergency Medical Associates v. Health Net of California, Inc. (2016) 1 Cal.5th 994. A health service plan delegated financial responsibility for its emergency services payments to individual practice associations who would be responsible for paying medical providers. The individual practice associations were alleged by plaintiff to not comply with State financial solvency requirements, and they did not in fact reimburse the plaintiff medical providers for emergency care that had been provided to enrollees of Health Net's system. Plaintiff brought an action seeking reimbursement. The Supreme Court concluded that the defendant Health Net's health care service plan owed a common law tort duty to non-contracting emergency service providers to act reasonably in delegating financial responsibility to an individual practice association and that the health care service plan may be liable to non-contracting emergency service providers for negligently delegating a contract to an individual practice association which Health Net knew or should have known could not reasonably be expected to provide reimbursement for non-contracting emergency service providers for their covered claims.
Contreras v. Dowling (2016) 4 Cal.App.5th 774. This is a SLAPP case. The tenant sued her landlords, their son and their former attorneys for alleged harassment and other claims arising out of allegedly illegal entries into the tenant's apartment. She then amended her pleadings to add the landlord's new attorney also as a defendant alleging that he had aided and abetted those wrongful entries. The attorney filed a SLAPP motion. The Court of Appeal held that the action against the current landlord's attorney did arise out of protected activity because the only actions the attorney was alleged to have taken were communicative acts by an attorney representing a client in pending or threatened litigation. Those acts consisted of giving advice to the client and writing a letter to opposing counsel. Acts of this nature are protected by CCP § 425.16. The allegations of aiding and abetting or conspiracy did not change the essential basis for the allegations against the landlord's attorney. The tenant also did not demonstrate a probability of prevailing on the merits because the attorney's communicative acts were also within the scope of the litigation privilege, Civil Code § 47(b).
Armin v. Riverside Community Hospital (2016) 5 Cal.App.5th 810. This is another SLAPP action. The plaintiff in this case, a doctor, brought a whistleblower action against a hospital and four other individual doctor defendants. The hospital filed a SLAPP motion as to the whistleblower cause of action on the basis that the plaintiff had not exhausted administrative remedies through the peer review process.
The Court of Appeal held that a physician need not complete the internal peer review process before bringing a whistleblower action under Health and Safety Code § 1278.5. The Court also held that the physician could not name other individual physician defendants in such a cause of action. The four individual doctor defendants were therefore properly dismissed. Plaintiff however made the necessary showing of retaliation on a prima facie basis when he demonstrated that he had complained to the hospital's Chief Operating Officer in December of 2011 about his colleague's approach to patients, and the following month one of those colleagues initiated a peer review proceeding against the plaintiff. That triggered the statutory presumption of retaliation set forth in Health and Safety Code § 1278.5(d)(1). Plaintiff had voiced complaints as well concerning religious discrimination prior to the peer review proceedings commencement and those religious discrimination claims were not based on activity which would be protected under the SLAPP statute, and the hospital's SLAPP motion was properly denied.