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California Pacific Regional Medical Center v. Global Excel Management, Inc.

United States District Court, Ninth Circuit

June 4, 2013



NATHANAEL M. COUSINS, Magistrate Judge.

The issue before the Court is whether there is an independent, private right of action for violation of California Health & Safety Code § 1371.4, a provision of the state's Knox-Keene Act mandating that health plans reimburse emergency services providers. For the reasons set forth below, the Court holds that no such private right of action exists and, therefore, GRANTS defendant's motion to dismiss the case without leave to amend.


Plaintiff ("California Medical Center") is a California non-profit corporation which provides medical care to patients. Dkt. No. 1 ¶ 2. Defendant ("Global") is a Canadian for-profit corporation, which is in the business of arranging for the provision of health care services to its enrollees and/or paying for or reimbursing the cost of those services. Id. ¶ 3. Between August 2, 2008 and August 5, 2008, California Medical Center provided emergency medical treatment to an individual with the initials H.R. who was enrolled in a health care service plan sponsored and/or administered by Global. Id. ¶ 8. California Medical Center submitted charges billed for H.R.'s emergency medical treatment to Global for payment. Id. ¶ 12. In response, Global submitted a payment of $38, 240.65, but has not paid the balance of $78, 346.71 that California Medical Center alleges is owed. Id. ¶¶ 12-14.

On February 7, 2013, California Medical Center filed this suit, alleging that Global's failure to fully reimburse the emergency services rendered to H.R. violated California Health & Safety Code § 1371.4(b). Id. ¶¶ 16-21. On April 4, 2013, Global filed a motion to dismiss the complaint under Federal Rule of Civil Procedure 12(b)(6). Dkt. No. 5. The Court held a hearing on the motion on May 15, 2013.

The Court has jurisdiction under 28 U.S.C. § 1332(a)(2). Dkt. No. 1 ¶¶ 1-3. The parties consented to the jurisdiction of a United States Magistrate Judge under 28 U.S.C. § 636(c). Dkt. Nos. 8-9.


To survive a motion to dismiss, a complaint must contain sufficient factual matter, accepted as true, to state a claim for relief that is plausible on its face. Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007); Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009). "The plausibility standard is not akin to a probability requirement, but it asks for more than a sheer possibility that a defendant has acted unlawfully.... Where a complaint pleads facts that are merely consistent with a defendant's liability, it stops short of the line between possibility and plausibility of entitlement to relief." Iqbal, 556 U.S. at 678 (quoting Twombly, 550 U.S. at 556-57) (internal quotation marks omitted). All allegations of material fact are taken as true and are construed in the light most favorable to the non-moving party. Coal. For ICANN Transparency, Inc. v. Verisign, Inc., 611 F.3d 495, 501 (9th Cir. 2010).


A. The Request for Judicial Notice of Legislative History Is Granted.

As a general rule, a court may not look to matters beyond the complaint without converting a motion to dismiss into one for summary judgment. Datel Holdings Ltd. v. Microsoft Corp., 712 F.Supp.2d 974, 983 (N.D. Cal. 2010) (Laporte, J.) (citations omitted). However, a court may take judicial notice of "material which is either submitted as part of the complaint or necessarily relied upon by the complaint, " as well as "matters of public record." Id. Under Federal Rule of Evidence 201(b), a judicially noticed fact must be one not subject to reasonable dispute in that it is either: (1) generally known within the territorial jurisdiction of the trial court; or (2) capable of accurate and ready determination by resort to sources whose accuracy cannot reasonably be questioned." See id.

Here, both parties request that the Court take judicial notice of unreported district court decisions. While a court may take judicial notice of another court's order, see Holder v. Holder, 305 F.3d 854, 866 (9th Cir. 2002), there is no need to do so here. The parties may cite to unreported district court decisions to the extent permitted by the local rules and the Court discusses these decisions below. See Civil L.R. 3-4(e), 7-14; see also Ninth Circuit Court of Appeals Rule 36-3.

In addition, Global requests that the Court take judicial notice of certain portions of the legislative history of California Health & Safety Code § 1371.4. California Medical Center does not oppose this request. Judicial notice of the legislative history of state statutes is appropriate under Federal Rule of Evidence 201. See, e.g., Hunt v. Check Recovery Systems, Inc., 478 F.Supp.2d 1157, 1160-61 (N.D. Cal. 2007). The Court grants Global's request for judicial notice as to ...

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