No Tort Liability for Insurer Underpayment of Hospital Bills

Author: Kristi Blackwell

Guest Editor: Kiran Gupta

December 3, 2021 9:00am

On November 4, 2021, the Second District Court of Appeal, Division 2, ruled against establishing tort liability for insurers who paid less than what the hospital believed to be the “reasonable and customary value.”  This partially published opinion is based on the underlying suit between plaintiffs Long Beach Memorial Medical Center and Orange Coast Memorial Medical Center (collectively “the hospitals”) and defendant Kaiser Foundation Health Plan, Inc. (“Kaiser”) stemming from alleged underpayment by Kaiser for emergency medical services rendered at the hospitals.

Medi-Cal Liens Not Preempted by Federal Medicaid Anti-Lien Statute

Author: David Kahn

Guest Editor: Grace Shuman

October 29, 2021 9:00am

Could a Medi-Cal lien for recovery of advanced medical expenses be pre-empted by federal law?  This was the issue recently decided by the Second District Court of Appeal in L.Q. v. California Hospital Medical Center.[i]  The case involves the conflict between federal and state law on whether a state’s Medicaid program can legally claim a lien against a beneficiary’s personal injury settlement without violating the anti-lien provision in the federal Medicare Act.  The Court of Appeal reversed the trial court and held the state Medi-Cal lien was valid, allowing recovery of the portion of the settlement proceeds to be attributable to past medical care paid for by Medi-Cal.

A Recent California Case Reminds Us of the Importance of Motions in Limine

Author: Kelley Harman

Guest Editor: Grace Shuman

October 29, 2021 9:00am

A strategic and thoughtfully prepared motion in limine can allow a party to assert control over the facts that will be presented to a jury and are a commonly used tool for raising evidentiary issues relating to expert witness testimony.  A successful motion in limine can shape the course of a trial. In Valderrama v. Beautologie Cosmetic Surgery, Inc., the use of thoughtful motions in limine to preclude irrelevant testimony and prevent plaintiffs’ experts from relying on the irrelevant testimony, allowed defendants to succeed at trial.

Connecting the Dots: Prep The Experts

Author: Kimberly Sayre

Guest Editor: Kiran Gupta

October 4, 2021 3:17pm

It is important to prepare experts for anything they may encounter on the stand. In Sampson v. Surgery Center of Peoria, the Supreme Court discussed an issue regarding testimony from an expert witness who testified in a medical malpractice case.

What Are the Limits of PREP Act Immunity for Senior Living Facilities?

Author: Aurora Levinson

Guest Editor: Kiran Gupta

September 7, 2021 9:00am

This article will discuss the origins of the PREP Act and its use as a tool to provide immunity from civil prosecution to senior living facilities from actions arising out of the COVID-19 pandemic. We will briefly review the history of the PREP Act, address its use to protect senior living facilities from prosecution during the pandemic, and address the limits of immunity and the next battlegrounds in litigation.

Copyright © 2001–2022 Tyson & Mendes LLP. All Rights Reserved. Website by Big Behavior.