DeVore v. Heritage Provider Network, Inc. (Summary)

EXHAUSTION OF ADMINISTRATIVE REMEDIES

DeVore v. Heritage Provider Network, Inc., B244534 (Cal. Ct. App. Nov. 22, 2013)

The California Court of Appeal reversed a lower court’s dismissal of a medical corporation’s complaint in a suit brought against several insurers alleging that the medical corporation’s fee-for-service contracts with the insurers were improperly terminated because of economic credentialing.  The insurers terminated the contracts per the contracts’ without cause provision.  The medical corporation sued, asserting causes of action for, among other things, wrongful termination and violation of due process. The insurers sought dismissal of the complaint, arguing that the medical corporation failed to exhaust its administrative remedies.  The lower court dismissed the complaint.  The appellate court reversed the lower court’s dismissal, holding that “[t]here is no allegation within the complaint or the judicially noticed letter that any procedure existed at any time during the parties’ contractual relationship to contest the terminations.”