Lin
Lin v. Board of Directors of PrimeCare Medical Network
Opinion
Opinion
Irion, J.
I.
FACTUAL AND PROCEDURAL BACKGROUND
In August 2020, Lin was employed as a medical doctor by San
Bernardino Medical Group, where he had worked since 1996.1 PrimeCare is a private corporation that is licensed as a health care service plan under the Knox-Keene Health Care Service Plan Act of 1975. (Health & Saf. Code, § 1340 et seq. (the Knox-Keene Act).) PrimeCare “contracts with full-service health plans such as Blue Shield and Blue Cross to provide medical care to health plan enrollees.” PrimeCare is responsible for conducting the peer review functions for San Bernardino Medical Group’s licensed health care
professionals.
The record reflects that at the time of the relevant events, although working for San Bernardino Medical Group, Lin’s employer was, more specifically, OptumCare Medical Group. As stated in the applicable findings in this matter, “Independent Practice Associations (IPAs), including PrimeCare of San Bernardino, contract with PrimeCare to provide a network of providers to render covered services to the full-service health plan members. IPAs contract with individual healthcare providers and medical groups (such as the San Bernardino Medical Group)…