Coast Plaza Doctors Hospital v. Blue Cross

99 Cal. Rptr. 2d 809, 83 Cal. App. 4th 677
CourtCalifornia Court of Appeal
DecidedSeptember 7, 2000
DocketB132500
StatusPublished
Cited by133 cases

This text of 99 Cal. Rptr. 2d 809 (Coast Plaza Doctors Hospital v. Blue Cross) is published on Counsel Stack Legal Research, covering California Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Coast Plaza Doctors Hospital v. Blue Cross, 99 Cal. Rptr. 2d 809, 83 Cal. App. 4th 677 (Cal. Ct. App. 2000).

Opinion

Opinion

CROSKEY, J.

In this case, appellant Blue Cross of California (Blue Cross) attacks the trial court’s denial of its motion to compel the arbitration of a dispute with respondent Coast Plaza Doctors Hospital (Coast Plaza). After Coast Plaza filed an action against Blue Cross on numerous tort theories, all related to the reimbursement rates paid by Blue Cross pursuant to a service agreement with Coast Plaza, Blue Cross filed a petition to compel arbitration of Coast Plaza’s claims. The service agreement contained an arbitration clause, but Coast Plaza argued that it did not apply because (1) Coast Plaza had terminated the agreement two days before filing suit, (2) its action sought injunctive relief which, as a matter of law, is not arbitrable, and (3) the arbitration provision was unconscionable and therefore unenforceable. The trial court denied Blue Cross’s motion.

After a review of the record, we are persuaded that the arbitration clause does apply to this dispute and is enforceable. Coast Plaza’s claim for injunctive relief can be severed and stayed pending the conclusion of the arbitration which may have the effect of resolving all issues between the parties. We therefore will reverse the order denying Blue Cross’s petition, issue an order staying all further proceedings in the trial court, including all discovery, pending completion of the arbitration, and remand for appropriate proceedings.

*681 Factual and Procedural Background 1

Coast Plaza is an acute care hospital operating in Norwalk, California. Blue Cross is a managed health care services provider. On January 1, 1996, Coast Plaza and Blue Cross entered into a comprehensive contracting service agreement (Service Agreement) under which Blue Cross agreed to reimburse Coast Plaza at set rates (hereinafter the Reimbursement Rates) for specified health care services supplied by Coast Plaza to patient members of Blue Cross’s health care plans. The Service Agreement was for an initial fixed term of two years, but was terminable thereafter upon 180 days’ written notice by either party. The Service Agreement also had a very broad arbitration clause. 2

For several months beginning in the fall of 1998 and ending in January 1999 Coast Plaza sought to renegotiate Blue Cross’s Reimbursement Rates. Coast Plaza claimed that it needed an increase in such rates if it were going to continue serving patients who were Blue Cross members; at the rates specified in the Service Agreement Coast Plaza lost money with respect to Blue Cross patients. When Blue Cross refused to negotiate satisfactorily higher Reimbursement Rates, Coast Plaza, in December of 1998, “informed” Blue Cross that it was terminating the Service Agreement, effective February 28, 1999. 3

Two days later, on March 2, 1999, Coast Plaza filed the instant action and alleged causes of action for (1) unfair trade practices in violation of Business and Professions Code section 17020 et seq., (2) unfair trade practices based on acts of intimidation, (3) intentional, and (4) negligent interference with prospective economic advantage, and (5) unfair business practices in violation of Business and Professions Code section 17200.

*682 The basic charging allegations upon which each of these causes of action is based are that Blue Cross’s Reimbursement Rates, as specified in the Service Agreement, are too low to allow Coast Plaza to recover its costs, much less make a profit. When Coast Plaza sought in, good faith, to renegotiate these rates Blue Cross unreasonably refused to consider or agree to any adequate increase, although it did agree to pay significantly higher rates to other larger hospitals in Southern California. Thus, Coast Plaza alleges Blue Cross discriminates against smaller hospitals in less affluent communities and does so with the purpose of putting them out of business. Indeed, Blue Cross unilaterally stated that if Coast Plaza did not accept a rate increase limited to .8 percent, Blue Cross would be forced to institute “certain administrative actions” which Coast Plaza interpreted to mean that all physicians and providers in the area would be advised not to utilize Coast Plaza for any Blue Cross patient services. All of this, Coast Plaza alleged, was done with the intent to “financially ruin Coast Plaza and other small hospitals who principally serve low-income patients and/or neighborhoods.” In effect, Blue Cross was depriving these smaller hospitals of access to a large segment of business controlled by Blue Cross and precluding low-income patients from seeking health care services from the chosen provider in the community. Coast Plaza claims that the Reimbursement Rates imposed by Blue Cross are unreasonable, discriminatory and anticompetitive, and will have a serious adverse financial impact on Coast Plaza. In its complaint, Coast Plaza sought both compensatory and punitive damages as well as injunctive relief.

As soon as permitted under Code of Civil Procedure section 2025, subdivision (a)(2), Coast Plaza initiated discovery proceedings. It served document production subpoenas on six hospitals seeking (1) records of reimbursement from Blue Cross for medical services provided to Blue Cross subscribers, (2) copies of contracts with Blue Cross, (3) internal documents relating to its negotiations with Blue Cross, (4) documents relating to any dispute with Blue Cross regarding reimbursement rates and amounts, and (5) records reflecting Blue Cross’s own evaluation of each hospital. Blue Cross objected to these broad discovery requests on a number of grounds, as did at least three of the hospitals involved. On April 1, 1999, Blue Cross filed a motion to quash these subpoenas.

On the same day Blue Cross also filed a petition to compel arbitration of the matters raised by Coast Plaza’s complaint. While it is true that the Service Agreement had been terminated by Coast Plaza, effective February 28, 1999, it provided (in par. 12.4) that: “After the effective date of termination, this Agreement shall remain in effect for the resolution of all *683 matters unresolved as of that date.” (Italics added.) Although, all of Coast Plaza claims sounded in tort, and its complaint was filed after the date of termination, Blue Cross argued that the dispute clearly arose under the Service Agreement and thus fell within the arbitration clause. Coast Plaza opposed the motion, arguing that the arbitration clause was unenforceable as it was unconscionable, did not apply since the Service Agreement had been terminated and, in any event, was precluded because Coast Plaza was seeking injunctive relief. Finally, Coast Plaza also contended that if the matter was sent to arbitration it would be deprived of needed discovery.

On May 14, 1999, the trial court denied the petition to compel arbitration. 4 It appears that the court’s ruling was “without prejudice on the grounds that more discovery was necessary to decide the issue.” Blue Cross filed a timely appeal on May 26, 1999.

Contentions of the Parties

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Cite This Page — Counsel Stack

Bluebook (online)
99 Cal. Rptr. 2d 809, 83 Cal. App. 4th 677, Counsel Stack Legal Research, https://law.counselstack.com/opinion/coast-plaza-doctors-hospital-v-blue-cross-calctapp-2000.