Three Southern California Hospitals Claim Kaiser Owes $3.8 Million
SANTA ANA, Calif. (CN) – Three southern California hospitals claim in Orange County Superior court that Kaiser owes them, collectively, $3.8 million for emergency patient care.
Anaheim Global Medical Center, Inc. (AGMC), Chapman Global Medical Center, Inc. (CGMC) and South Coast Global Medical Center, Inc. (SCGMC) sued Kaiser Foundation Hospitals and Kaiser Foundation Health Plan, Inc. for breach of implied contract, quantum meruit, restitution, account stated, health and safety code violations, intentional violation of the duty to timely pay for emergency medical services, injunctive and equitable relief under the business and professions code and declaratory relief.
“Plaintiffs receive, among others, emergency patients in and around Orange County based on the patients’ location, assessed need and proximity to facilities offering the required level of care. Plaintiffs do not control the inflow of such patients; plaintiffs are informed and believe, and thereon allege, the County of Orange, through its administration of the County’s Emergency Medical Services system, and individual patients, exercise such control,” the complaint states.
Both state and federal laws require the plaintiffs to provide care under such circumstances, according to the complaint.
AGMC, CGMC and SCGMC contend Kaiser is aware of their customary rates and should pay them, but have been inconsistent in doing so.
“In some instances, defendants paid more than half the bill; in others, less than half; in yet others, denied the claims altogether and paid nothing. Occasionally, defendants have held payment on large patient claims hostage unless plaintiffs’ staff ‘agreed’ to accept a far lesser rate of reimbursement. Defendants have also consistently failed to pay plaintiffs in a timely manner as required by law,” the complaint states.
AGMC claims Kaiser owes it $2 million, CGMC claims Kaiser owes it $500,000 and SCGMC claims Kaiser owes it $1.3 million.
AGMC, CGMC and SCGMC seek restitution, disgorgement, punitive and exemplary damages, injunctive and declaratory relief, the greater of $15 per unpaid account or interest of 15 percent per annum, costs and attorneys’ fees. They are represented by David A. Robinson and Roxanne I. Kraft of Enterprise Counsel Group in Irvine.