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Anthem Fights Failed Doc Group’s Tabs At Calif. High Court

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Law360
September 9, 2016

Andrew Selesnick, Damaris Medina and Robin James were mentioned in the article "Anthem Fights Failed Doc Group’s Tabs At Calif. High Court," published in Law360 on September 8, 2016. The article addresses Andrew Selesnick’s argument, on behalf of emergency physicians, before the California Supreme Court in the matter of California Centinela Freeman Emergency Medical Associates et al. v. Health Net of California Inc. et al.. The case has tremendous significance in the health care industry as the Court’s opinion will directly impact the reimbursement obligations placed on HMO’s throughout California. The question before the Court is whether emergency physicians can sue health insurance companies for negligently delegating payment responsibility to an Independent Physicians Association (IPA) when they knew, or should have known, that the IPA was not financially stable. Mr. Selesnick argued that, because emergency rooms are required by law to provide services, regardless of patients’ ability to pay, there is a strong public policy interest in favor of ensuring that emergency service providers get paid for their work.

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