Hospital Says Kaiser Owes Nearly $500K for Patient Treatment
3-10-2017 23:41:00

LOS ANGELES (CN) – Presbyterian Intercommunity Hospital claims Kaiser refuses to pay nearly $500,000 for medically necessary services, in a complaint filed in Los Angeles County Superior Court.

Presbyterian, dba PIH Health Hospital-Downey, sued Kaiser Foundation Health Plan, alleging breach of oral contract, breach of implied-in-fact contract, and quantum merit.
Since Oct. 26, 2014, the hospital says, it has provided medically necessary services and equipment to at least 107 of Kaiser’s patients. When it contacted Kaiser to verify if Kaiser was responsible for the costs of those services, Kaiser confirmed that it was.
Believing Kaiser’s representations, Presbyterian continued admitting and treating Kaiser patients. Costs of treatment totaled at least $751,038.79, which the hospital submitted to Kaiser in a “timely and proper” manner, according to the complaint.
Despite its prior statements, Kaiser refused to pay for all medically necessary services rendered, and still owes at least $494,432.78, the complaint states.
Had it known Kaiser would refuse to pay, Presbyterian says, it could have made alternative arrangements for patient care or pursued other sources of payment.
The hospital seeks the $494,432.78 owed, plus interest at a rate of 15 percent per annum.
It is represented by Joy Stephenson with Stephenson, Acquisto & Colman of Burbank.