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Case Summary
4058 REVIEW DENIED Under the Knox-Keene Act, a health plan's statutory duty to reimburse non-contracted providers for emergency services rendered to plan members requires payment of a reasonable and customary amount. Citation BELL v BLUE CROSS (Emergency Service) 131 CA4 211 [See: B&PC 17200 etseq; H&SC 1340 etseq; 28 CCR 1300.71(a)(3); CA Medical Assn v Aetna 94 CA4 151, T/AT 1/02]

2005 Case Summaries

JAN: 3930 | 3931 | 3932 | 3933 | 3934 | 3935 | 3936 | 3937 | 3938 | 3939 | 3940 | 3941 | 3942 | 3943 | 3944 | p0699 | p0700 | p0701 | p0702 | p0703 | p0704 | p0705 | p0706 | p0707 | p0708 | p0709 | p0710 | p0711 | p0712 | p0713 | p0714 | p0715 | p0716 | p0717 | p0718 | p0719 | p0720 | p0721 | p0722 | p0723 | p0724 | p0725 | p0726 |
FEB: 3945 | 3946 | 3947 | 3948 | 3949 | 3950 | 3951 | 3952 | 3953 | 3954 | 3955 | 3956 |
MAR: 3957 | 3958 | 3959 | 3960 | 3961 | 3962 | 3963 | 3964 | 3965 | 3966 | 3967 | 3968 | 3969 | 3970 | 3971 | 3972 | 3973 | 3974 | 3975 | 3976 | 3977 | 3978 | 3979 | p0727 | p0728 | p0729 | p0730 | p0731 | p0732 | p0733 | p0734 | p0735 | p0736 | p0737 | p0738 | p0739 | p0740 | p0741 | p0742 | p0743 | p0744 | p0745 | p0746 | p0747 | p0748 | p0749 | p0750 | p0751 | p0752 | p0753 | p0754 | p0755 | p0756 | p0757 | p0758 | p0759 | p0760 | p0761 | p0762 | p0763 | p0764 | p0765 | p0766 | p0767 | p0768 | p0769 | p0770 | p0771 | p0772 | p0773 | p0774 | p0775 | p0776 |
APR: 3980 | 3981 | 3982 | 3983 | 3984 | 3985 | 3986 | 3987 | 3988 | 3989 | 3990 | 3991 |
MAY: 3992 | 3993 | 3994 | 3995 | 3996 | 3997 | 3998 | 3999 | 4000 | 4001 | 4002 | 4003 | 4004 | 4005 | 4006 | 4007 | 4008 | 4009 | 4010 | p0777 | p0778 | p0779 | p0780 | p0781 | p0782 | p0783 | p0784 | p0785 | p0786 | p0787 | p0788 | p0789 | p0790 | p0791 | p0792 | p0793 | p0794 | p0795 | p0796 | p0797 | p0798 | p0799 | p0800 | p0801 | p0802 | p0803 | p0804 | p0805 | p0806 | p0807 | p0808 | p0809 | p0810 | p0811 | p0812 | p0813 |
JUN: 4011 | 4012 | 4013 | 4014 | 4015 | 4016 | 4017 | 4018 | 4019 | 4020 | 4021 | 4022 | 4023 | 4024 | 4025 | 4026 | 4027 | 4028 | 4029 | 4030 |
JUL: 4031 | 4032 | 4033 | 4034 | 4035 | 4036 | 4037 | 4038 | 4039 | 4040 | 4041 | 4042 | 4043 | 4044 | 4045 | 4046 | 4047 | 4048 | 4049 | 4050 | p0814 | p0815 | p0816 | p0817 | p0818 | p0819 | p0820 | p0821 | p0822 | p0823 | p0824 | p0825 | p0826 | p0827 | p0828 | p0829 | p0830 | p0831 | p0832 | p0833 | p0834 | p0835 | p0836 | p0837 | p0838 | p0839 | p0840 | p0841 | p0842 | p0843 | p0844 | p0845 | p0846 | p0847 | p0848 | p0849 | p0850 | p0851 |
AUG: 4051 | 4052 | 4053 | 4054 | 4055 | 4056 | 4057 | 4058 | 4059 | 4060 | 4061 | 4062 | 4063 | 4064 | 4065 | 4066 | 4067 | 4068 | 4069 |
SEP: 4070 | 4071 | 4072 | 4073 | 4074 | 4075 | 4076 | 4077 | 4078 | 4079 | 4080 | 4081 | 4082 | 4083 | 4084 | 4085 | 4086 | 4087 | 4088 | 4089 | 4090 | 4091 | 4092 | 4093 | p0852 | p0853 | p0854 | p0855 | p0856 | p0857 | p0858 | p0859 | p0860 | p0861 | p0862 | p0863 | p0864 | p0865 | p0866 | p0867 | p0868 | p0869 | p0870 | p0871 | p0872 | p0873 | p0874 | p0875 | p0876 | p0877 | p0878 | p0879 | p0880 |
OCT: 4094 | 4095 | 4096 | 4097 | 4098 | 4099 | 4100 | 4101 | 4102 | 4103 | 4104 | 4105 | 4106 | 4107 | 4108 | 4109 |
NOV: 4110 | 4111 | 4112 | 4113 | 4114 | 4115 | 4116 | 4117 | 4118 | 4119 | 4120 | 4121 | 4122 | p0881 | p0882 | p0883 | p0884 | p0885 | p0886 | p0887 | p0888 | p0889 | p0890 | p0891 | p0892 | p0893 | p0894 | p0895 | p0896 | p0897 | p0898 | p0900 | p0901 | p0902 | p0903 | p0904 | p0905 | p0906 | p0907 | p0908 | p0909 | p0910 | p0911 | p0912 |
DEC: 4123 | 4124 | 4125 | 4126 | 4127 | 4128 | 4129 | 4130 | 4131 | 4132 | 4133 | 4134 | 4135 |

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