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B307407
Cal. Ct. App.
Dec 6, 2022
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Background

  • 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)
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Case Details

Case Name: State of California v. Fishman CA2/2
Court Name: California Court of Appeal
Date Published: Dec 6, 2022
Citation: B307407
Docket Number: B307407
Court Abbreviation: Cal. Ct. App.
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    State of California v. Fishman CA2/2, B307407