Justia California Court of Appeals Opinion Summaries

The People filed a complaint charging defendants with causing, aiding, and abetting the illegal delivery of marijuana. The trial court granted an injunction barring defendants from further developing or marketing their marijuana delivery app. At issue on appeal is whether Proposition D, L.A. Mun. Code, 45.19.6, which City voters enacted in 2013 to regulate medical marijuana businesses, generally prohibits the delivery of marijuana by vehicles. The court concluded that the City established a likelihood of proving defendants’ app caused, aided, or abetted the violation of Proposition D because, outside of the narrow exception for designated primary caregivers, it prohibits the vehicular delivery of medical marijuana to qualified participants, identification card holders, or primary caregivers in the City. Further, defendants’ opposition to the City’s unfair competition allegations necessarily fails because the City has demonstrated a likelihood of success on its claim that defendants facilitated a violation of Proposition D. In this case, defendants made no showing at all concerning the balance of hardships, much less that the balance tipped sharply in their favor. Accordingly, the court affirmed the trial court's judgment. View "People v. Nestdrop, LLC" on Justia Law

Heather W. appealed an order reappointing the Public Guardian as her conservator under the Lanterman-Petris-Short Act (LPS Act), Welf. & Inst. Code, 5000 et seq. The court concluded that the trial court erred by not advising Heather W. of her right to a jury trial and not obtaining her on-the-record personal waiver of that right without a finding that she lacked the capacity to make a jury waiver. The court further concluded that a remand is required for the trial court to determine whether Heather W. "lacked the capacity to make a knowing and voluntary waiver at the time of counsel's waiver." The court rejected Heather W.'s claims that the trial court's comments show it shifted the burden of proof, relied on statements by the Public Guardian's counsel instead of evidence, and did not apply the gravely disabled standard. The court reviewed the parties' remaining contentions and concluded that they will not change the result the court has reached. Accordingly, the court reversed the order and remanded for further proceedings. View "San Luis Obispo Cnty. Public Guardian v. Heather W." on Justia Law

The Board issued an administrative investigative subpoena seeking complete, certified records of three of plaintiff's patients on the grounds that there was good cause to believe that plaintiff departed from the standard of care in connection with the treatment of those patients. Plaintiff's petitions to quash the subpoena were denied, and the Board’s petition to compel compliance was granted in part, with the limitation that the records to be provided should be limited by time period. The court concluded that the Board had pointed out specific instances of prescribing irregularities, which were sufficient for a finding of good cause; substantial evidence supports the trial court’s finding of good cause; and there is no abuse of discretion in the trial court’s determination that Dr. Pollak was qualified to render an expert opinion in this matter. The court also concluded that plaintiff failed to convince the court that, if the evidence of medical records at issue was obtained in violation of Civil Code section 56.26, the Board was not permitted to use it in the investigation. While the trial court may not have specifically stated it was engaging in a balancing test, the long discussion of good cause shows careful consideration of the patients’ right to privacy versus the state’s interest in safeguarding its citizens from negligent medical care. Finally, the court rejected plaintiff's claim that the subpoena was overbroad where the trial court did not err in failing to modify the subpoena in more ways than it already did in applying time restrictions. Accordingly, the court affirmed the judgment. View "Fett v Medical Bd. of CA" on Justia Law

Legislation, effective in 2004 requires that injured workers’ requests for medical treatment be evaluated through a process called utilization review (UR). Under the UR process, a request for treatment cannot be denied by a claims adjustor and must be approved unless a clinician determines that the treatment is medically unnecessary. Workers can challenge decisions denying requested treatment, but employers cannot challenge decisions approving it. The 2004 legislation called for administrative adoption of uniform standards for physicians to use in evaluating treatment. In 2013, additional reforms went into effect, establishing a new procedure, independent medical review (IMR), to resolve workers’ challenges to UR decisions. Stevens challenged the constitutionality of the IMR process, arguing that it violated the state Constitution’s separation of powers clause, its requirements that workers’ compensation decisions be subject to review and the system “accomplish substantial justice,” and principles of due process. The court of appeal rejected those claims, but remanded Stevens’s request for a home health aid. The Legislature has plenary powers over the workers’ compensation system under article XIV, section 4 of the state Constitution. California’s scheme for evaluating workers’ treatment requests is fundamentally fair and affords workers sufficient opportunities to present evidence and be heard. View "Stevens v. Workers' Comp. Appeals Bd," on Justia Law

UEBT is a healthcare employee benefits trust governed by the Employee Retirement Income Security Act (ERISA), 29 U.S.C. 1001, and pays healthcare providers directly from its own funds for the services provided to enrollees in its health plans. UEBT contracted with a “network vendor,” Blue Shield, to obtain access to Blue Shield’s provider network at the rates Blue Shield had separately negotiated, and certain administrative services. One of Blue Shield’s preexisting provider contracts was with Sutter, a group of health care providers in Northern California. UEBT sued Sutter, on behalf of a putative class of all California self-funded payors, alleging that Sutter’s contracts with network vendors, such as Blue Shield, contain anticompetitive terms that insulate Sutter from competition and drive up the cost of healthcare. UEBT sought damages, restitution, and injunctive relief under the Cartwright Act (Bus. & Prof. Code 16720) and California’s unfair competition law (section 17200). Sutter moved to compel arbitration, relying on an arbitration clause in the provider contract signed by Sutter and Blue Shield. The trial court denied Sutter’s motion, concluding that UEBT was not bound to arbitrate its claims pursuant to an agreement it had not signed or even seen. The court of appeal affirmed. View "UFCW & Employers Benefit Trust v. Sutter Health" on Justia Law

Kevin A. appeals from an order granting the Public Conservator's petition to establish conservatorship for a one-year period. The court found him to be gravely disabled under the Lanterman-Petris-Short Act, Welf. & Inst. Code, 5000 et seq. In light of the recent California Supreme Court decisions in People v. Blackburn and People v. Tran, the court agreed with Kevin that the trial court erred in accepting a waiver of jury trial over his objection and request. Accordingly, the court reversed the order granting the petition. View "In re Kevin A." on Justia Law

Pursuant to federal law, California’s Medi-Cal program requires beneficiaries to use other health coverage (OHC) they may have before accessing Medi-Cal benefits. The state Department of Health Care Services (DHCS) maintains a database with codes that indicate whether a Medi-Cal beneficiary has OHC and, to some extent, the scope of that coverage. The codes are available to providers when a beneficiary seeks services. Medi-Cal beneficiaries filed suit. Because DHCS allegedly permits Medi-Cal providers to refuse nonemergency services to beneficiaries with OHC, and because the codes are not always correct and the information is limited, beneficiaries may be improperly denied service and referred to other providers even when there is no OHC available for the requested service; beneficiaries may experience delays in receiving nonemergency care and may be subject to a higher copayment than permitted under Medi-Cal. Plaintiffs argued that the assignment of an OHC code should trigger notice and a hearing. The trial and appeals courts rejected their arguments. Neither Welfare and Institutions Code 10950 nor regulation 50951 nor the California Constitution requires DHCS to provide a hearing or notice when it assigns an OHC code. Plaintiffs did not establish any violation of a ministerial duty subject to enforcement by a writ of mandate. View "Marquez v. Dept. of Health Care Servs." on Justia Law

Plaintiff filed a class action against HCP, alleging causes of action for violation of the unfair competition law (UCL), Bus. & Prof. Code, 7200 et seq.; common law fraudulent concealment; and violation of the false advertising law (FAL), Bus. & Prof. Code, 17500. Plaintiff argued that, although HCP does not fall within the literal definition of a “health care service plan” as defined in Health and Safety Code section 1345, subdivision (f)(1), due to the level of risk it assumed, HCP operated as a health care service plan without obtaining the license required by the Knox-Keene Health Care Service Plan Act of 1975, Health and Safety Code section 1340 et seq., and without meeting the regulatory mandates required of health care service plans. The trial court sustained without leave to amend the demurrers filed by HCP and entered a judgment of dismissal. The court concluded that the trial court acted within its discretion in invoking the abstention doctrine as to the statutory causes of action but not as to the common law cause of action for fraudulent concealment. However, the court found that plaintiff failed to plead a claim for fraudulent concealment, and that she has failed to demonstrate how she could amend the operative complaint to cure the defect. Accordingly, the court affirmed the judgment. View "Hambrick v. Healthcare Partners Med. Grp." on Justia Law

This case involved the County's approval of a no-bid contract for pharmacy administrator services under the Affordable Care Act (ACA), 42 U.S.C. 300gg et seq. On appeal, the County challenged the trial court's judgment against it. The court agreed with the County that the trial court failed to accord sufficient deference to the County’s evaluation of its needs for the services of a pharmacy administrator who could provide the necessary data management and provision of pharmaceuticals to address its needs in implementing provisions of the ACA. Accordingly, the court reversed with directions that the trial court enter judgment in favor of the County. View "Weinstein v. County of Los Angeles" on Justia Law

After Chan’s mother died from internal hemorrhaging related to Coumadin use following heart surgery, Chan successfully sued Curran for medical malpractice. Chan challenged the trial court’s post-verdict reduction of the $1 million noneconomic damages award to $250,000, as required by the Medical Injury Compensation Reform Act of 1975 (MICRA), Civ. Code 3333.2. Chan challenged the MICRA cap as violating equal protection, due process and the right to jury trial, based on her assertion she is entitled to seek noneconomic damages sufficient to cover attorney fees. The court of appeal rejected Chan’s claims, stating that the legitimate debate over the wisdom of MICRA’s noneconomic damages cap remains a matter for the Legislature and state electorate. View "Chan v. Curran" on Justia Law