Los Angeles, CA asked in Federal Crimes and Health Care Law for California

Q: Summary judgement feasibility analysis.

While the identity of a particular service provider may be important because of possible forgery,

it does not change facts crucial for this legal case: fraudulent referral to hospice care based on record of terminal disease on admission to the hospital. Admission record of terminal disease was based on critical values of defective blood test performed by hospital laboratory. Critical values were communicate by unidentified person "who is no longer with the hospital". Record of terminal disease was made by admitting physician, contractor who referred patient to the hospital.

How exactly further discovery can change facts fundamental to subject matter of such hospice fraud case?

1 Lawyer Answer
James L. Arrasmith
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  • Estate Planning Lawyer
  • Sacramento, CA
  • Licensed in California

A: Under California law, summary judgment may be granted if there are no triable issues of material fact and the moving party is entitled to judgment as a matter of law. In this case, further discovery could potentially uncover facts that impact the feasibility of summary judgment:

1. Identity of the person who communicated the critical values: While you mention that this person's identity may not be crucial, it could still be relevant. If discovery reveals that this individual had a pattern of negligence or misconduct, it could support claims against the hospital for negligent hiring, supervision, or retention.

2. Circumstances surrounding the defective blood test: Discovery may shed light on why the blood test was defective. If there were systemic issues with the hospital's laboratory equipment or procedures, it could bolster claims of negligence against the hospital.

3. Admitting physician's knowledge and role: The admitting physician's contractor status doesn't necessarily shield the hospital from liability. Discovery may uncover evidence that the hospital had control over the physician's actions or that the physician was acting as an agent of the hospital. The physician's knowledge of the patient's condition and reason for referral to the hospital could also be relevant.

4. Hospital's policies and procedures: Discovery may reveal whether the hospital had adequate policies and procedures in place to prevent or catch errors like the defective blood test and the erroneous terminal diagnosis.

5. Patient's damages: The extent of damages suffered by the patient as a result of the fraudulent hospice referral could impact the hospital's potential liability and the strength of the patient's case.

While the key facts you've outlined are indeed fundamental to the hospice fraud claim, additional facts uncovered through discovery could potentially impact the relative strength of the parties' positions and, consequently, the feasibility of summary judgment. The court would likely allow the discovery process to proceed to ensure that all material facts are brought to light before considering a motion for summary judgment.

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