Workers’ Bid for $4.1 Million in Health Claims Revived on Appeal

A health fund covering unionized workers wrongly denied more than $4.1 million in claims by refusing to treat a California surgical clinic as a hospital eligible to charge facility fees, the Ninth Circuit held.

Advanced Pain Treatment Medical Center is accredited to perform outpatient surgery, and the ILWU-PMA Welfare Plan erred by focusing on the center’s lack of a state license that’s no longer issued, the US Court of Appeals for the Ninth Circuit said Wednesday. The court’s unpublished, split opinion sent the dispute back to district court for more analysis, saying a “close review of the extensive record” will ...