94 Cal.App.5th 166
Cal. Ct. App.2023Background
- Moran, a self-pay patient, visited Huntington Beach Hospital three times in 2013, signed conditions of admission, and received bills that included Evaluation and Management Services (EMS) fees totaling $3,568.80 and over $10,000 in billed charges overall.
- Moran previously appealed, and this court held he had standing to challenge alleged unconscionability of self-pay rates (Moran v. Prime Healthcare Management, Inc.).
- In his sixth amended complaint Moran added a new theory: defendants unlawfully failed to disclose EMS fees in the emergency department (no signage, oral notice, or written notice at registration/discharge), bringing UCL, CLRA, and declaratory-relief claims tied to that nondisclosure.
- Defendants moved to strike the EMS-fee allegations, arguing statutory and regulatory disclosure requirements (chargemaster availability, OSHPD filings, and related federal rules) define hospitals’ disclosure duties and preclude extra ER-specific notices.
- The trial court struck the EMS-fee allegations; the Court of Appeal affirmed, holding the requested additional disclosures would conflict with the comprehensive state and federal scheme balancing price transparency and prompt emergency care.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Duty to provide ER-specific notice/signage of EMS fees beyond chargemaster/OSHPD posting | Moran: hospitals must post or orally disclose EMS fees in ER so patients aren’t surprised | Hospital: disclosure obligations are defined by statute/regulation (chargemaster availability, OSHPD filing); additional ER notice would conflict with emergency-care policy | No duty to provide ER-specific notice; striking EMS-fee allegations affirmed |
| CLRA failure-to-disclose (Civil Code § 1770(a)(5), (a)(14)) | Moran: exclusive knowledge and intentional concealment of EMS fees; CLRA entitles relief for nondisclosure | Hospital: EMS fees disclosed in chargemaster as required; plaintiff failed to plead reliance or causation | CLRA claims based on EMS nondisclosure fail for lack of duty beyond statute and insufficient reliance allegations |
| UCL (unlawful/unfair/fraudulent practice) tethering to legislatively-declared policy | Moran: nondisclosure of EMS fees is an unfair/unlawful practice tied to CLRA and public policy | Hospital: legislature and regulators struck a balance (transparency vs. not deterring emergency care); no basis to impose extra disclosure duty under UCL | UCL claim based on EMS nondisclosure fails; statutory scheme forecloses extra disclosure-based UCL theory |
| Procedural vehicle — motion to strike vs. demurrer/summary adjudication | Moran: motion to strike was improper; summary adjudication or demurrer was the right vehicle | Hospital: motion to strike is proper to excise substantively defective portions of a cause of action (PH II line) | Motion to strike was proper; court may strike defective portion of pleading when defect clear on face of complaint |
Key Cases Cited
- Moran v. Prime Healthcare Management, Inc., 3 Cal.App.5th 1131 (Cal. Ct. App. 2016) (prior appeal holding plaintiff had standing to challenge unconscionability)
- Nolte v. Cedars-Sinai Med. Ctr., 236 Cal.App.4th 1401 (Cal. Ct. App. 2015) (statutory disclosure scheme forecloses CLRA/UCL claim based on additional fee disclosures)
- Gray v. Dignity Health, 70 Cal.App.5th 225 (Cal. Ct. App. 2021) (no duty to provide ER-specific signage or individualized pre-treatment notice of ER charge; regulatory balance favors immediate care)
- Torres v. Adventist Health Sys./West, 77 Cal.App.5th 500 (Cal. Ct. App. 2022) (charged-party’s reasonable-access allegations can be relevant, but CLRA claims failed for lack of reliance)
- Saini v. Sutter Health, 80 Cal.App.5th 1054 (Cal. Ct. App. 2022) (followed Gray; no CLRA duty to post additional ER signage beyond chargemaster disclosures)
- Naranjo v. Doctors Med. Ctr. of Modesto, 90 Cal.App.5th 1193 (Cal. Ct. App. 2023) (allowed similar nondisclosure claims to proceed; created conflict now under review)
- Cel‑Tech Commc’ns, Inc. v. Los Angeles Cellular Tel. Co., 20 Cal.4th 163 (Cal. 1999) (UCL claims tied to public policy must be tethered to specific statutory/regulatory provisions)