Ralph Barnett v. Kaiser Foundation Health Plan, Inc.

Ralph Barnett belonged to Kaiser Foundation Health Plan, Inc. (“Kaiser”), a Health Maintenance Organization (“HMO”). After consulting with various doctors about his deteriorating health condition, Barnett formally requested financial approval from Kaiser for a liver transplant. Kaiser denied Barnett coverage. Following an expedited trial, the district court denied Barnett’s request for a permanent injunction requiring Kaiser to pay for the costs of his liver transplant. Barnett appeals that decision. We have jurisdiction under 28 U.S.C. § 1292 , and we affirm.

I.

FACTS AND PRIOR PROCEEDINGS

Ralph Barnett is inflicted with Hepatitis B, further classified as e-antigen positive. The “e-antigen positive” characterization indicates that he is infected with a large amount of the virus and that the virus is replicating rapidly outside the liver. E-antigen positive status carries with it a greater risk that a new liver could become infected with the virus.

Barnett, through his employment with Magnolia Upholstery, entered into an ERISA-regulated service agreement with Kaiser in 1990. Kaiser contracts with The Permanente Medical Group (“Medical Group”) to provide health services to its…