The opinion of the court was delivered by: Legge, District Judge.
Defendants St. Francis Memorial Hospital (the "Hospital") and
Catholic Healthcare West ("CHW") (collectively "defendants") move
for summary judgment on the first amended complaint ("FAC").
Plaintiff cross-moves for partial summary judgment, seeking: (1)
an injunction restraining defendants from asserting or collecting
on the hospital lien discussed below; and (2) an order stating
that the funds currently held in trust pendente lite be
disbursed to Grauberger.
The underlying facts are not significantly in dispute.
Plaintiff was injured in an automobile collision on January 14,
1998. She received treatment for her injuries at the Hospital
between April 20 and April 24, 1998 and again between January 19
and January 23, 1999. She alleges that her group insurance policy
— issued by Blue Cross as part of the employee benefit plan of
United Airlines, her spouse's employer — paid the hospital its
negotiated rates in full except for the deductible amounts and
copayments, which plaintiff paid herself.*fn1 See FAC at ¶¶
Grauberger brought suit against Loren Holden, the driver who
allegedly caused the accident ("tortfeasor"). FAC at ¶ 7. The
Hospital then filed a lien in that action pursuant to the
Hospital Lien Act ("HLA"), California Civil Code sections
3045.1-3045.6, seeking to recover the balance of its "regular
rates," i.e., the difference between the Hospital's normal
rates and the negotiated rates that it charged to Grauberger as a
plan member.*fn2 Grauberger settled the suit with Holden for
$100,000. After deducting attorneys' fees and costs, the net
proceeds to plaintiff from the settlement totaled
$63,495.48.*fn3 Plaintiff and defendants have placed half of
this figure, or $31,747.74, in trust pending resolution of this
suit. See FAC at ¶ 11.
Plaintiff's first amended complaint states eight claims for
relief: (1) conversion; (2) fraudulent concealment; (3) unfair
business practices; (4) breach of contract; (5) violation of
public policy; (6) interference with contract; (7) abuse of
process; and (8) violation of civil RICO. Plaintiff seeks
declaratory and injunctive relief as well as treble damages.
Plaintiff also seeks to certify a class consisting of "all other
patients of defendants' facilities who are insured by private
insurance and to whom treatment is rendered on account of
accidental injury and who make claim against third party
tortfeasors for recovery." FAC at ¶ 13.*fn4
Defendants removed the action to federal court because it
involves RICO allegations and is "related to" an ERISA plan.
Defendants maintain that the HLA authorizes a hospital that
provides services to any person injured in an accident to file a
lien, in the amount of the hospital's "reasonable and necessary
charges," against any damages recovered by the injured person.
They point out that a lien can be placed on damages recovered by
"judgment, settlement or compromise." Defendants contend that
they are not double billing plaintiff; instead they seek
"additional compensation from the third party tortfeasor
responsible for the patient's injuries, not from the patient."
Summary judgment should be granted if "there is no genuine
issue as to any material fact and . . . the moving party is
entitled to a judgment as a matter of law." Fed.R.Civ.P. 56(c).
"Where the record taken as a whole could not lead a rational
trier of fact to find for the non-moving party, there is no
`genuine issue for trial.'" Matsushita Elec. Industrial Co. v.
Zenith Radio, 475 U.S. 574, 587, 106 S.Ct. 1348, 89 L.Ed.2d 538
(1986) (citing First National Bank of Arizona v. Cities Service
Co., 391 U.S. 253, 289, 88 S.Ct. 1575, 20 L.Ed.2d 569 (1968)).
"At the summary judgment stage, the district court is not to
weigh the evidence or determine the truth of the matter but
should only decide whether there is a genuine issue for trial."
Washington v. Garrett, 10 F.3d 1421, 1428 (9th Cir. 1993)
(citing Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 249, 106
S.Ct. 2505, 91 L.Ed.2d 202 (1986)).
The moving party bears the initial responsibility of "informing
the district court of the basis for its motion, and identifying
those portions of `the pleadings, depositions, answers to
interrogatories, and admissions on file, together with the
affidavits, if any,' which it believes demonstrate the absence of
a genuine issue of material fact." Celotex Corp. v. Catrett,
477 U.S. 317, 323, 106 S.Ct. 2548, 91 L.Ed.2d 265 (1986) (quoting
When the nonmoving party will bear the burden of proof at trial
on a dispositive issue, the nonmoving party must then "go beyond
the pleadings and by her own affidavits, or by the `depositions,
answers to interrogatories and admissions on file,' designate
`specific facts showing that there is a genuine issue for
trial.'" Id. at 324, 106 S.Ct. 2548 (quoting Fed.R.Civ.P. 56(c)
& (e)). The court views all facts and draws all inferences
therefrom in the light most favorable to the nonmoving party.
United States v. Diebold, Inc., 369 U.S. 654, 655, 82 S.Ct.
993, 8 L.Ed.2d 176 (1962). If, however, the ...