California Supreme Court Watch

Jul 16, 2014
#14-76 Centinela Freeman Emergency Medical Associates v. Health Net of California, Inc., S218497

#14-76 Centinela Freeman Emergency Medical Associates v. Health Net of California, Inc., S218497.  (B238867; 225 Cal.App.4th 237; Los Angeles County Superior Court; BC449056.) Petition for review after the Court of Appeal reversed the judgment in a civil action. This case presents the following issues: (1) Does the delegation — by a health care service plan (HMO) to an independent physicians association (IPA), under Health and Safety Code section 1371.4, subdivision (e) — of the HMO’s responsibility to reimburse emergency medical service providers for emergency care provided to the HMO’s enrollees relieve the HMO of the ultimate obligation to pay for emergency medical care provided to its enrollees by non-contracting emergency medical service providers, if the IPA becomes insolvent and is unable to pay? (2) Does an HMO have a duty to emergency medical service providers to protect them from financial harm resulting from the insolvency of an IPA which is otherwise financially responsible for the emergency medical care provided to its enrollees?

Review granted 07/16/2014 – Oral Argument 09/08/2016 

See the Petition for Review.