PacifiCare

California Emergency Physicians Medical Group v. PacifiCare

Caution
111 Cal. App. 4th 1127·2003 Cal. App. LEXIS 1376·2003 Daily Journal DAR 10125·4 Cal. Rptr. 3d 583·2003 Cal. Daily Op. Serv. 8137
Court of Appeal of CaliforniaSeptember 5, 2003D040034California4,086 words

Opinion

Opinion

O'Rourke, J.

California Emergency Physicians Medical Group (Emergency Physicians) provided emergency medical services for patients who had contracted for medical insurance with PacifiCare of California and PacifiCare of California doing business as Secure Horizons (collectively PacifiCare) and who chose Family Health Network (FHN) as their medical provider. FHN failed to pay Emergency Physicians for the emergency medical services it provided. Emergency Physicians sued PacifiCare to recover the value of those services.

The court sustained PacifiCare’s demurrer without leave to amend. We affirm.

FACTUAL AND PROCEDURAL HISTORY

According to the allegations in the complaint, Emergency Physicians is a professional corporation that provides emergency medical services at Alvarado Hospital Medical Center. PacifiCare is a health care service plan licensed by the State of California under the Knox-Keene Health Care Services Plan Act (Knox-Keene Act) (Health & Saf. Code, § 1340 et seq.). PacifiCare contracted with FHN to provide health care services, including emergency medical services, to PacifiCare members who chose FHN as their medical provider.

FHN filed for bankruptcy and went out of…

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