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Supreme Court of California Case Notification for Children’s Hospital Central California v. Blue Cross of California
On October 17, 2014 in
Blog
,
California
,
Health Insurance
,
Supreme Court
In an important legal development in the healthcare cost debate, the California Supreme Court has denied a petition for review of the recent decision in Children’s Hospital of Central California v. Blue Cross of California, 226 Cal. App.4th 1260 (2014). You’ll recall that a few months ago, a California appellate court reversed a decision by the trial court holding Blue Cross responsible for the full billed charges because the jury found that an implied-in-fact contract existed between the Hospital and Blue Cross. In so doing, the jury awarded the hospital $6.6 million in addition to the $4.2 million Blue Cross had already paid, totaling a payment of $10.8 million. This decision set up a potential showdown in the California Supreme
Court; but
the showdown is not to be. As a result benefit plans get important legal support for the proposition that a hospital cannot be paid an amount simply because they charge for it.
See the full appellate decision
here
.
Stay tuned as the
the California
courts try to determine on remand what should be considered when determining the “reasonable and customary” value of services rendered.
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