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Calif. Justices Say HMOs Can Face Unpaid Emergency Bills

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Law360
November 14, 2016

Andrew Selesnick was quoted in the article, "Calif. Justices Say HMOs Can Face Unpaid Emergency Bills," published in Law360 on November 14, 2016. M&R Attorneys Damaris Medina and Robin James were also acknowledged. The article addresses the California Supreme Court's finding that Anthem Blue Cross, Health Net, Aetna and other major health plans can be held liable when a contracted independent physicians association fails, ruling insurers cannot delegate payment responsibility to associations they know will not be able to pay. Representing the prevailing emergency physicians, Andrew Selesnick noted that "with this decision, the California Supreme Court has championed the notion that emergency service providers should get paid for their work, and that HMOs cannot simply absolve themselves of their obligations to these providers by negligently delegating payment responsibility to third parties."

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