Dameron Hospital Ass'n v. AAA Northern California Nevada & Utah Insurance Exchange

Under California law, hospitals must provide emergency room services without regard for a patient’s ability to pay or who will ultimately bear responsibility for the medical bill. (Prospect Medical Group, Inc. v. Northridge Emergency Medical Group (2009) 45 Cal.4th 497, 501-502 [ 87 Cal.Rptr.3d 299 , 198 P.3d 86 ] (Prospect).) Depending on who pays the bill for emergency room services, billing rates for the same treatment can vary substantially. (Howell v. Hamilton Meats & Provisions, Inc. (2011) 52 Cal.4th 541, 552, 560 [ 129 Cal.Rptr.3d 325 , 257 P.3d 1130 ] (Howell).) After patients have received their care, hospitals often face the difficult and complex task of trying to secure payment for the emergency room services. The final cost and identity of the responsible payer of the emergency room services can remain unresolved for years.

Sometimes a patient needs emergency room care due to negligent driving by a third party tortfeasor with automobile liability insurance coverage. In such an instance, the hospital with the emergency room must determine whether the medical bills are the responsibility of the patient, the patient’s health care service plan, the tortfeasor,…