Appeals
We regularly represent physicians and other healthcare providers in appeals concerning such topics as peer review, medical staff privileges, and the rights of providers against federal, state, and local government and third party payors. Some representative successes on appeal include:
- In Potvin v. Metropolitan Life Insurance Company (2000), Fenton Nelson won a landmark victory in the California Supreme Court that established the precedent that a physician has a right to a hearing before being terminated or deselected by HMO’s and insurance companies.
- In Sahlolbei v. Providence Healthcare (2003), we established the right of a physician to maintain staff privileges at a hospital, while facing non reappointment, until all internal remedies under the medical staff bylaws are exhausted.
- In Hayes v. Cedars Sinai (2004), Fenton Nelson established the right of a physician to a hearing when his application for staff privileges was denied.
- In In re Pomona Valley Medical Group, Inc. (2007), Fenton Nelson persuaded the Ninth Circuit Court of Appeals that a physician may pursue state law claims against a healthcare network that had filed for bankruptcy.
- In Bode v. Los Angeles Metropolitan Medical Center (2009), Fenton Nelson won a victory clarifying that the medical staff may not discipline a physician for wrongdoing unless they prove the allegations by a preponderance of the evidence.
These cases are but a few of the many important appeals that Fenton Nelson has secured victories on behalf of providers. We have also secured victories for hospitals, including reinstating a lawsuit against an insurance company in San Joaquin Hospital v. Pacificare. We are frequently requested to file amicus briefs in leading healthcare cases.
In addition to our appellate practice in the courts, our extensive writ practice involves many appeals of administrative actions by such agencies as the Medical Board of California, the Department of Health Care Services, and other state and federal agencies.
