Rodriguez v. Eisenhower Medical Center CA4/2

CourtCalifornia Court of Appeal
DecidedFebruary 3, 2022
DocketE075172
StatusUnpublished

This text of Rodriguez v. Eisenhower Medical Center CA4/2 (Rodriguez v. Eisenhower Medical Center CA4/2) 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
Rodriguez v. Eisenhower Medical Center CA4/2, (Cal. Ct. App. 2022).

Opinion

Filed 2/3/22 Rodriguez v. Eisenhower Medical Center CA4/2

NOT TO BE PUBLISHED IN OFFICIAL REPORTS California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified for publication or ordered published, except as specified by rule 8.1115(b). This opinion has not been certified for publication or ordered published for purposes of rule 8.1115.

IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA

FOURTH APPELLATE DISTRICT

DIVISION TWO

LEONOR RODRIGUEZ,

Plaintiff and Appellant, E075172

v. (Super.Ct.No. PSC1706058)

EISENHOWER MEDICAL CENTER, OPINION

Defendant and Respondent.

APPEAL from the Superior Court of Riverside County. Sunshine S. Sykes, Judge.

Affirmed.

McCune Wright Arevalo, Richard D. McCune, Michele M. Vercoski, Steven A.

Haskins and Tuan Q. Nguyen for Plaintiff and Appellant.

Jones Day and Nathaniel P. Garrett for Defendant and Respondent.

1 Plaintiff Leonor Rodriguez appeals from a judgment dismissing her complaint

against defendant Eisenhower Medical Center after the trial judge granted the hospital’s

motion for summary judgment. Rodriguez alleged Eisenhower violated California’s

Unfair Competition Law (UCL) (Bus. & Prof. Code, § 17200 et seq.) by failing to

adequately disclose the facility fee associated with her outpatient procedure. She alleged

she would have gone elsewhere for the procedure had she known of the fee.

In granting Eisenhower’s motion, the judge concluded the evidence indisputably

demonstrated the hospital complied with the applicable pricing disclosure obligations

contained in Health and Safety Code section 1339.511 (part of the “Payers’ Bill of

Rights”) and thus had acted both lawfully and fairly under the UCL. Rodriguez argues

the judge misinterpreted the evidence and dismissed her lawsuit in error. We disagree and

affirm.

I

FACTS

A. The Payers’ Bill of Rights

A hospital’s duty to inform patients about anticipated pricing before they receive

treatment is defined by a series of statutes in the Health and Safety Code called the

Payers’ Bill of Rights. (§ 1339.50 et seq.) Enacted in 2003, the Payers’ Bill of Rights

recognizes the importance of pricing transparency and endeavors to strike a balance

between a consumer’s right to make informed choices and the burden of disclosure on

1 Unlabeled statutory citations refer to the Health and Safety Code. 2 hospitals. In this vein, the Payers’ Bill of Rights does not require hospitals to directly

disclose anticipated fees and charges to patients in all circumstances. Rather,

pretreatment disclosures are required only when an uninsured patient seeks a

nonemergency service. (§ 1339.585.)2

In all other circumstances, a hospital meets the Legislature’s standard of pricing

transparency by giving patients access to a “uniform schedule of . . . its gross billed

charge for a given service or item, regardless of payer type.” (§ 1339.51, subd. (b)(1).)

This schedule is called a “charge description master” or “chargemaster,” and should

contain a “list of all the billable medical goods or services” a hospital provides. (Sarun v.

Dignity Health (2019) 41 Cal.App.5th 1119, 1125.)

There are two requirements for providing adequate chargemaster access under the

Payers’ Bill of Rights—availability and notice. A hospital must make “a written or

electronic copy of its charge[master] available, either by posting an electronic copy . . .

[on its] Web site, or by making one written or electronic copy available at the hospital

location.” (§ 1339.51, subd. (a)(1).) A hospital must also “post a clear and conspicuous

notice in its emergency department, if any, in its admissions office, and in its billing

office that informs patients that the hospital’s charge[master] is available in the manner

described in subdivision (a).” (§ 1339.51, subd. (c).) The Legislature imposed these

disclosure obligations with the goal that “making public the chargemaster . . . will bring

2 While this appeal was pending, the Legislature amended section 1339.585 to remove the condition that the uninsured patient request the fee disclosure. (See former § 1339.585.) Now, a hospital must provide the disclosure whether or not the patient requests it. 3 more transparency to hospital billing practices.” (Assem. Com. On Appropriations, 3d

reading analysis of Assem. Bill No. 1637 (2003-2004) as amended May 23, 2003, p. 2.)

B. Rodriguez’s Lawsuit

Eisenhower is a licensed hospital that provides 24-hour inpatient care at its main

campus in Rancho Mirage and also maintains a number of outpatient facilities in the low

desert area. In 2014, 2015, and 2016, Rodriguez underwent elective hyaluronic acid knee

injections for the treatment of arthritis at one such outpatient facility, the Desert

Orthopedic Center (DOC) in La Quinta.

In November 2018, Rodriguez filed the operative complaint in Riverside Superior

Court, a putative class action lawsuit alleging that she and others similarly situated who

received treatment at the DOC were charged a “facility fee” which Eisenhower failed to

adequately disclose under section 1339.51. Specifically, she alleged the hospital failed to

post a copy of their chargemaster on their web site and failed to post chargemaster

notices in the required areas (emergency, administrative, and billing departments) as well

as in the DOC. She alleged these violations of section 1339.51 constituted both unlawful

and unfair business practices under the UCL.

According to the factual allegations in her complaint, Rodriguez received three

knee injections in 2014 and another three in 2015. On each of those occasions, DOC staff

provided her with a “Conditions of Admissions” form advising she would be billed both a

“provider” fee and a “facility” fee for each visit. At that time, she was covered by an

4 HMO insurance policy through Healthnet under which she paid a minimal copay amount

for each visit.

In 2016, Rodriguez switched to a PPO insurance policy through Anthem Blue

Cross. She informed DOC staff about the change, and, after looking into her new policy,

they contacted her to let her know the injections were still covered. That year, the total of

Rodriguez’s out-of-pocket medical bills for the three injections was $3,810, and she

believed the facility fees made up about $3,489 of that total.

Rodriguez alleged she was harmed by Eisenhower’s failure to adequately disclose

their facility fee, because had she known the amount she was going to be responsible for

under her new insurance policy, she would have either switched back to her previous

policy or “sought medical care at a medical office not owned by a hospital,” as facility

fees are unique to hospitals.

C. Eisenhower’s Motion for Summary Judgment

After the parties engaged in discovery, Eisenhower filed a motion for summary

judgment, arguing Rodriguez’s UCL claim failed because the undisputed evidence

showed they had complied with section 1339.51’s disclosure requirements. In support of

their argument, Eisenhower attached a declaration from Hallary Scheideman, their

chargemaster coordinator and analyst, who is responsible for maintaining and updating

their chargemaster. Scheideman said she prepared Eisenhower’s chargemaster in 2016,

5 submitted it to the Office of Statewide Health Planning and Development (OSHPD), and

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