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Health plans win summary judgement over doctor directory claims

Daily Journal

The Daily Journal summarized Judge Gregory W. Pollack's ruling in favor of client Kaiser Foundation Health Plan and two other defendants: Molina Healthcare of California and Centene's HealthNet in People v. Kaiser Foundation Health Plan Inc., 37-2021-00027298-CU-BT-CTL (S.D. Cal). 

San Diego City Attorney Mara W. Elliot filed the lawsuits in June 2021 claiming that the companies’ directories were inaccurate regarding their list of in-network care providers and did not follow the law. On Sept. 19, the Court ruled the case would not proceed because the court was being asked to become a regulator where the California Department of Managed Health was already operating. The defense presented evidence they said showed that the companies had complied with requests from the department, updating the directories as needed to correct names. The court order also said the city attorney’s method for determining if the companies had inaccurate information on the directories was unreliable.

Summary judgments were issued in favor of Kaiser Foundation Health Plan, Molina Healthcare of California and Centene’s HealthNet over claims that the companies published directories listing doctors and other providers not covered by patients’ plans.

Moe Keshavarzi, John Brooks, and Samuel Duimovich represented Kaiser.

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