California Supreme Court Watch

#22-01 Quishenberry v. UnitedHealthCare, Inc., S271501. (B303451; nonpublished opinion; Los Angeles County Superior Court; BC631077.) Petition for review after the Court of Appeal affirmed the judgments in a civil action. This case presents issues regarding the preemption of claims for negligence, elder abuse, and wrongful death pursuant to the Medicare Part C preemption clause (42 U.S.C. § 1395w-26(b)(3)).

Review granted: 1/05/2022

Case fully briefed: 5/09/2022

Cause argued and submitted: 5/10/2023

Opinion filed: Judgment affirmed in full: 7/13/2023

See the Court of Appeal Opinion.

See the Petition for Review.

See the Oral Argument.

See the California Supreme Court Opinion.  (Quishenberry v. UnitedHealthCare, Inc. (2023) 14 Cal.5th 1057.)

“This case concerns a Medicare Advantage (MA) enrollee who died after being discharged from a skilled nursing facility. The enrollee’s son, Larry Quishenberry, sued the MA health maintenance organization (HMO) plan and a healthcare services administrator that managed his father’s MA benefits. Quishenberry pled state-law claims for negligence, wrongful death, and elder abuse based on allegations that the HMO and healthcare services administrator breached a duty to ensure his father received skilled nursing benefits to which he was entitled under his MA plan.

The HMO and healthcare services administrator assert that Quishenberry’s claims are expressly preempted by Medicare Part C’s preemption provision, which provides that the “standards established under” Part C “shall supersede any State law or regulation” concerning MA plans. (42 U.S.C. § 1395w26(b)(3).) Because Quishenberry’s state-law claims are based on allegations that his father’s HMO plan and healthcare services administrator breached state-law duties that incorporate and duplicate standards established under Part C, we agree and hold that the provision preempts them.”

Justice Groban authored the opinion of the Court, in which Chief Justice Guerrero and Justices Corrigan, Liu, Kruger, Jenkins, and Evans concurred.