- (Self-Referral) Disclosure of financial interest to patients did not excuse a physician when he referred patients to other entities that he owned. Sanjoy Banerjee v. The Superior Court of Riverside County (People) (No. E076291 Super. Ct. No. RIF1802535 California Court of Appeal Fourth Appellate District Division Two Filed October 5, 2021)
- (Hearsay) A Kelly Blue Book website’s valuation of a vehicle was admissible evidence for purposes of proving the vehicle’s worth exceeded $950 because it is a published compilation. The People v. Tyrus Romealus Jenkins (No. G059110 Super. Ct. No. 19NF2186 California Courts of Appeal Fourth Appellate District Division Three Filed October 12, 2021)
- (Personal Jurisdiction) Specific personal jurisdiction is established where tort occurs in state even though defendant is just a visitor. Jane Doe v. Scott Damron (No. A161078 Napa County Super. Ct. No 19CV001762 California Court of Appeal First Appellate District Division Five Filed October 20, 2021)
- (Special Relationship Doctrine) The Archdiocese owed a duty to protect a plaintiff taking classes at a Catholic church because a special relationship existed. John HG Doe v. The Roman Catholic Archbishop of Los Angeles (No. B305810 Los Angeles County Super. Ct. No. BC679844 California Courts of Appeal Second Appellate District Division Seven Filed October 20, 2021)
- (Arbitration) Because an agent was authorized to sign an arbitration agreement on behalf of the principal with respect to her personal care, there was a valid arbitration agreement. Janet Gordon v. Atria Management Company, LLC (No. A161379 Contra Costa County Super. CT. No. MSC2001023 California Courts of Appeal First Appellate District Division Five Filed October 27, 2021)
The above referenced court opinions have come to our attention during last month. Please find below a brief summary of these opinions for your consideration.
- (Self-Referral) Disclosure of financial interest to patients did not excuse a physician when he referred patients to other entities that he owned. Sanjoy Banerjee v. The Superior Court of Riverside County (People) (No. E076291 Super. Ct. No. RIF1802535 California Court of Appeal Fourth Appellate District Division Two Filed October 5, 2021)
The petitioner, a physician, was charged with two counts of presenting a false or fraudulent health care claim to an insurer. The court denied the petitioner’s motion to dismiss as unsupported by reasonable or probable cause. The petitioner filed a writ of prohibition, directing the superior court to vacate its order denying the petitioner’s motion.
The petitioner allegedly billed a workers’ compensation insurer for services he rendered to patients through this professional corporation and through two other legal entities he owned and controlled. The insurance fraud charges were based upon the billings by the petitioner to the insurer through the two other entities. The charges also included a perjury charge based upon three instances in which the petitioner signed doctor’s reports, certifying under penalty of perjury that he had not violated Labor Code section 139.3. Section 139.3(e) prohibits a physician from referring patients to other persons or entity for specified services, to the extent the services are to be paid pursuant to the workers’ compensation system, if the physician or his or her immediate family has a financial interest with a person or any entity receiving the referral.
The petitioner stated that the charges should have been set aside. First, he claimed that the evidence showed he did not violate the referral prohibition of section 139.3(e), because he complied with the written patient disclosure requirement contained within section (e), of the section. Section 139.3(e) requires a physician who refers a patient to, or who seeks a consultation from, an organization in which the physician has financial interest to disclose the financial interest to the patient in writing at the time of the referral. The petitioner claimed that a physician’s compliance with this section excused the physician’s noncompliance with the referral prohibition of section 139.3(a). Second, the petitioner claimed that even if he did not comply with section 139.3(e), the “physician’s office” exception to the referral prohibition of section 139.3(a) applies to all of his referrals to his two other legal entities. He maintained that he treated all of the patients for all of the services he provided to them at the same office location, and that the physician’s office exception of section 139.3(e) does not prohibit a physician from rendering services through separate legal entities.
The appeals court noted that to date there were no published court decisions interpreted sections 139.3 or 139.31. The appeals court concluded that a physician’s compliance with a disclosure requirement of section 139.3(e) did not excuse the physician’s noncompliance with the referral prohibition of section 139.3(a), and that section 139.3(a) and 139.3(e) were neither in conflict not unconstitutionally vague. The appeals court found that the petitioner did not violate section 139.3(a) with regard to the perjury charges. However, the evidence supported a strong suspicion that the petitioner specifically intended to present false and fraudulent claims for health care benefits, in violation of Penal Code section 550, by billing a workers’ compensation insurer substantially higher amounts through his two other legal entities, then he previously and customarily had billed the insurer for the same services he formerly rendered through his professional corporation and his former group practice. Thus, the appeals court granted the writ of prohibition as to the perjury charge but denied it as to the insurance fraud charges.
- (Hearsay) A Kelly Blue Book website’s valuation of a vehicle was admissible evidence for purposes of proving the vehicle’s worth exceeded $950 because it is a published compilation. The People v. Tyrus Romealus Jenkins (No. G059110 Super. Ct. No. 19NF2186 California Courts of Appeal Fourth Appellate District Division Three Filed October 12, 2021)
This matter involved a criminal jury trial in which the defendant was convicted of first degree burglary of a residence with a person present, as well a second degree burglary of a car. The defendant contended his conviction for attempted unlawful taking of a vehicle should have been reversed because the court permitted, over his objection, a police detective to testify to the car’s estimated value obtained from Kelly Blue Book’s website. The defendant asserted this was hearsay evidence that should have been excluded, and absent this testimony, there was no evidence establishing the care was worth more than $950, an element of the felony offense. The appeals court concluded that trial court properly admitted the evidence under Evidence Code section 1340, the published compilation exception to the hearsay rule. The appeals court affirmed that trial court’s ruling and affirmed the judgment. Section 1340 of the Evidence Code provides that evidence of statement of fact contained in a published compilation is admissible if the compilation is generally used and relied upon as accurate in the course of business. The appeals court held that the trial court properly admitted evidence of the car’s value from Kelly Blue Book because each of these elements have been satisfied. The appeals court determined that the Kelly Blue Book was a compilation because it compiles information about vehicle values, which vary depending on the type of car, its condition, amenities, location, and type of sale. The evidence also suggested that Kelly Blue Book is generally used and relied upon as accurate in the course of business because the detective in this case testified he regularly used and relied upon Kelly Blue Book in determining the value of vehicles as a police officer and specifically as a detective in the auto theft and burglary unit.
- (Personal Jurisdiction) Specific personal jurisdiction is established where tort occurs in state even though defendant is just a visitor. Jane Doe v. Scott Damron (No. A161078 Napa County Super. Ct. No 19CV001762 California Court of Appeal First Appellate District Division Five Filed October 20, 2021)
While traveling in California, a man assaulted and injured his spouse. Both persons lived in Georgia. The spouse brought a tort action in a California court. The court concluded that it lacked personal jurisdiction over the assailant and dismissed the action. The appeals court reversed and held that, absent compelling circumstances that would make the suit unreasonable, a court may exercise jurisdiction over a non-resident who commits a tort while present in the state. The appeals court found that the requirement for specific jurisdiction were met when the defendant injures a plaintiff in the state where the tort occurred and which is also the state where the plaintiff seeks jurisdiction. A single, brief visit can establish jurisdiction.
- (Special Relationship Doctrine) The Archdiocese owed a duty to protect a plaintiff taking classes at a Catholic church because a special relationship existed. John HG Doe v. The Roman Catholic Archbishop of Los Angeles (No. B305810 Los Angeles County Super. Ct. No. BC679844 California Courts of Appeal Second Appellate District Division Seven Filed October 20, 2021)
In this case, the question presented to the appellate division was whether a church had a duty to protect children from sexual abuse by clergy while the children are attending religious school or participating in other church-sponsored programs. The appeals court answer to the question was yes, and reversed the judgment entered in the trial court, which answered that question no, granting a motion for summary judgment by the defendant. The plaintiff had alleged that at the age of 10, he was molested by clergy while attending catechism classes at the parochial school. Plaintiff filed an action against the defendant contending that the defendant had a duty to protect him while he was entrusted to the care at the parochial school. Defendant moved for summary judgment, arguing it did not owe a duty of care to plaintiff because it did not know or have reason to know that the clergy had molested minors prior to the plaintiff.
The appeals court found that the special relationship doctrine is an exception to the general rule that there is no duty of protect others from the conduct of third parties. A special relationship doctrine is one that gives the victim a right to expect protection from the defendant, often found in cases involving minors where adults and organizations act as quasi-parents by assuming responsibility when the parents are not present. Here, the appellate division found the defendant owed a duty of care to the plaintiff because of circumstances in this case satisfied the common features of a special relationship.
- (Arbitration) Because an agent was authorized to sign an arbitration agreement on behalf of the principal with respect to her personal care, there was a valid arbitration agreement. Janet Gordon v. Atria Management Company, LLC (No. A161379 Contra Costa County Super. CT. No. MSC2001023 California Courts of Appeal First Appellate District Division Five Filed October 27, 2021)
Plaintiffs signed a Durable Power of Attorney (DPOA) agreement that authorized her son to enter into transactions necessary to provide for the plaintiff’s personal care, including making arrangements to commit the plaintiff into a residential care facility and demanding, arbitrating and litigating on plaintiff’s behalf. The DPOA expressly stated that it did not authorize the son to make healthcare decisions for the plaintiff. The plaintiff moved into a residential care facility and the plaintiff’s son signed a one-page Agreement to Arbitrate Disputes in California that required the parties to arbitrate civil actions. The plaintiff suffered a fall and broke her hip. The plaintiff filed a lawsuit against the residential care facilities Management Company alleging elder neglect and abuse. Defendant filed a petition to compel arbitration based on the Arbitration Agreement. In opposition, the plaintiff contended that the arbitration clause was not enforceable because it was not signed by the plaintiff or an agent pursuant to a valid power of attorney for healthcare. The trial court ruled that the plaintiff’s son lacked the authority to bind the plaintiff to the Arbitration Agreement because the plaintiff’s son lacked the authority to make healthcare decisions. The defendant appealed.
The appellate court reversed and remanded the matter. It found that the DPOA was executed in connection with the plaintiff’s residential care, and thus, it fell under the power to make residential care arrangements. Moreover, the power to submit claims to litigation or arbitration reasonably includes the right to decide that future claims to arbitrated and litigated in court. The court concluded that admitting the plaintiff to the facility was not a healthcare decision, because the complaint stated that the purpose for admitting the plaintiff was to obtain supervision and assistance with daily living, rather than to obtain medical care. Therefore, the appeals court found that the trial court erred in concluding that the plaintiff’s son lacked authority to bind the plaintiff to the Arbitration Agreement.
Should you have any questions concerning these court decisions or desire a copy of any of them, please do not hesitate to contact our office.