Allied Anesthesia etc. v. Inland Empire etc. CA4/2
Plaintiffs are medical groups with anesthesia medical practices. IEHP is the local initiative Medi-Cal managed care plan that “operates under a joint powers agreement between Riverside and San Bernardino Counties to provide health coverage for Medi-Cal participants. [It] arranges and pays for medical services to plan members by contracting with [independent practice associations] and others for the delivery of those services.” (Inland Empire Health Plan v. Superior Court (2003) 108 Cal.App.4th 588, 590 (IEHP v. Superior Court), disapproved on other grounds in Quigley v. Garden Valley Fire Protection Dist. (2019) 7 Cal.5th 798, 814.) Riverside and San Bernardino Counties have adopted a two-plan model for Medi-Cal managed care. “Under the Two-Plan Model, a county requires its Medi-Cal beneficiaries to enroll in one of two managed care plans: a public entity HMO known as a ‘local initiative,’ or a commercial HMO.
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