Prime Healthcare Centinela v. United Healthcare Ins. Co. CA2/5
Opinion
Opinion
FACTS AND PROCEDURAL BACKGROUND
I. Facts
Prime Healthcare (Prime) operates hospitals throughout Southern California, including in Chino Valley, Huntington Beach, Sherman Oaks, and Anaheim (collectively, the hospitals); each has an emergency department.1 Since January 1, 2020, these hospitals have provided emergency services to patients who have health insurance with United Healthcare Insurance Company, Inc. (United) or who are members of the UHC of California, Inc. health insurance service plan (UHC), even though the hospitals are not part of United or UHC’s network of providers. United and UHC have “ma[de] payments” to Prime “on a large number of claims,” but in what Prime views as “inadequate amounts.”
II. Procedural Background
A. Complaint On March 9, 2022, Prime sued United and UHC for (1) quantum meruit, (2) open book account, and (3) violation of California’s Unfair Competition Law (Bus. & Prof. Code, § 17200
1 The corporate names of the five hospitals are (1) Prime Healthcare Centinela, LLC, dba Centinela Hospital Medical Center; (2) Veritas Health Services, Inc., dba Chino Valley Medical Center; (3) Prime Healthcare Huntington Beach, LLC, dba Huntington…