B307407
Cal. Ct. App.Dec 6, 2022Background
- Dr. Bruce Fishman pled guilty in 1983 to a federal conspiracy to distribute a controlled substance; his California medical license was later reinstated after rehabilitation and probation was terminated.
- Fishman became a Qualified Medical Examiner (QME) for California workers’ compensation in 2003 and was reappointed multiple times.
- Relators (initially Nazemi, GLC Operations, Med‑Legal; later Med‑Legal and GLCI in the FAC) filed a qui tam action alleging Fishman hid his felony on his QME application and submitted fraudulent medical reports/billings (2003–2014) in violation of the Insurance Frauds Prevention Act (IFPA).
- Med‑Legal previously pursued arbitration against Fishman alleging failure to disclose the felony; the arbitrator issued an award for Fishman, and that award was ultimately confirmed in separate proceedings.
- The trial court granted Fishman’s motion for judgment on the pleadings, concluding collateral estoppel and the IFPA statute of limitations barred the IFPA claim; it entered judgment, awarded Fishman attorney fees, and added Nazemi and GLC Operations as judgment debtors.
- The Court of Appeal reversed the judgment, holding the trial court erred in applying collateral estoppel and that the IFPA limitations period is measured by each allegedly fraudulent claim/report submission (so some claims fell within the limitations period); the fee and debtor rulings were rendered moot by the reversal.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether judgment on the pleadings was proper under collateral estoppel | Prior arbitration decided same issues against relators, so relitigation barred | Arbitration and Medical Board findings resolve the same facts; relators/privity exist | Reversed: collateral estoppel did not apply — issues and parties/privity were not the same |
| Whether IFPA claims are time‑barred | Statute begins when Fishman made the alleged misrepresentation (2003), so claims are stale | Claims are time‑barred because the alleged fraud occurred in 2003 (outside 8‑year limit) | Reversed: limitations measured by each fraudulent claim/report submission; some claims fell within statutory period |
| Award of attorney fees to Fishman | Relators: fee award erroneous because judgment should not bind nonparties and issues remain | Fishman: fees proper against relators and related entities for meritless litigation | Moot on appeal (reversal of judgment); court did not decide merits of fee award here |
| Addition of Nazemi and GLC Operations as judgment debtors | Objectors: they were not parties and should not be added; no alter‑ego proof | Fishman: Nazemi and entities are the real instigators/alter egos and should bear fees/costs | Moot on appeal (reversal); trial court’s factual finding of alter‑ego not reviewed here |
Key Cases Cited
- Hernandez v. City of Pomona, 46 Cal.4th 501 (2009) (elements and application of collateral estoppel)
- Burd v. Barkley Court Reporters, Inc., 17 Cal.App.5th 1037 (2017) (judgment on the pleadings reviewed like demurrer; de novo review)
- Genis v. Schainbaum, 66 Cal.App.5th 1007 (2021) (pleadings yield to inconsistent judicially noticed documents/exhibits)
- Groves v. Peterson, 100 Cal.App.4th 659 (2002) (collateral estoppel may be applied if judicially noticed records show bar)
- San Francisco Unified School Dist. ex rel. Contreras v. Laidlaw Transit, Inc., 182 Cal.App.4th 438 (2010) (rules of statutory construction and legislative intent)
- State of California ex rel. Nee v. Unumprovident Corp., 140 Cal.App.4th 442 (2006) (purpose of IFPA is to prevent and punish fraudulent insurance claims)
- People v. Chong, 76 Cal.App.4th 232 (1999) (professionalism and ethical restraints on disparaging litigation conduct)
