Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 1 of 33 Page ID #:1

1 Edward R. Ulloa (SBN 177909)

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2 Kevin lt Warren (SBN 242238)

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3 MEMBERS OF:
IIAWKINS PARNELL THACKSTON & YOUNG LLP 4 444 South Flower Street, Suite 11 00
Los Angeles, CA 90071 5 Telephone: (213) 486-8000

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Attorneys for Plaintiffs

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THE UNITED STATES DISTRICT COURT FOR THE

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Cv 10. 41\Ij:a 9

CENTRAL DISTRICT OF CALIFORNIA

10

11 SIERRA MEDICAL SERVICES

CaseNo.

RSil! ~

ALLIANCE, CARE FLIGHT, RIGGS

12 AMBULANCE SERVICE INC.,

COMPLAINT FOR INJUNCTIVE

SCHAEFER AMBULANCE SERVICE,

RELIEF, DECLARATORY RELIEF AND

13 INC. AMERICAN AMBULANCE OF

DAMAGES; DEMAND FOR JURY

VISALIA, DESERT AMBULANCE

TRIAL

14 SERVICE, SAN LUIS AMBULANCE

SERVICE_. ]NC,. .E,IRST RESPONDER

15 EMERGEl>;CY NruDICAL SERVICES-

SACRAMENTO, INC., FIRST

16 RESPONDER EMERGENCY MEDICAL

SERVICES, INC., IMPERIAL

17 AMBULANCE SERVICES, INC., EXETER

DISTRICT AMBULANCE SIERRA

18 LIFESTAR, INC., d.b.a, LIFESTAR

AMBULANCE, DEL NORTE

19 AMBULANCE, INC., PINER'S

AMBULANCE, INC., AMERICAN

20 LEGION POST 108 AMBULANCE

SERVICE, PROGRESSIVE AMBULANCE,

21 INC., d.p~~LIBERTY AMBULANCE,

HALL AlVillULANCE SERVICE, INC.,

22 CITY AMBULANCE OF EUREKA INC.,

PATTERSON DISTRICT AMBULANCE,

23 K.W.P.H. ENTERPIRSES, d.b.a.,

AMERICAN AMBULANCE

24 COMMUNITY AMBULANCE SERVICES,

INC., SIERRA AMBULANCE SERVICE,

25 INC., CARE AMBULANCE SERVICE,

INC., DELANO AMBULANCE SERVICE,

26 INC., KERN EMERGENCY MEDICAL

TRANSPORTATION CORPORATION-"

27 d.b.:~;:.,..JSERN AMBULANCE, MANTEcA

DIS iKiCT VOLUNTEER AMBULANCE

28 SERVICE, dba MANTECA DISTRICT

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1
COMPLAINT

Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 2 of 33 Page ID #:2

1 AMBULANCE SERVICE,

2
3
vs.
4

Plaintiffs,

5 DAVID MAXWELL-JOLLY, Director ofthe Department of Health Care Services, State of
6 California, CALIFORNIA DEPARMENT OF HEALTH CARE SERVICES,
7
Defendants.
8

9
JURISDICTION
10
1. This action involves federal questions ansmg under the laws and 11 constitution of the United States, including, but not limited to, 42 U.S.C. 1395, et seq.,
12
42U.S.C. 1396 et seq., 42 U.S.C. 1983 and the Fifth and Fourteenth Amendments to
13
the United States Constitution. This Court has subject matter jurisdiction over this
14
action pursuant to 28 U.S.C. §§ 1331, 1343, 2201 and 2202. In addition, this Court
15
may exercise pendent jurisdiction over any state law claims that are present in this
16
matter.
17

18
2. Venue is proper in the Central District because a substantial part of the
19
events or omissions giving rise to the claim occurred in this District. In addition, all 20
Defendants reside in this State and Defendants have agreed that an action against them
21
may be commenced in any city in which the Attorney General of the state has an
22
office. The Attorney General has an office in this District. 23

24
INTRODUCTION
25
3. Plaintiffs provide medical transportation servtces to over 20 million 26
Californians in 31 of the State's 58 counties, covering more than half of California's
27
population. Plaintiffs stand ready to assist these 20 million Californians in emergency 28

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COMPLAINT

Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 3 of 33 Page ID #:3

1 situations seven days a week, 24 hours a day. Plaintiffs also provide non-emergency

2 ambulance services to those Californians who have a special need and who do not

3 have a reliable source of transportation to obtain essential treatment at regular

4 appointments. Plaintiffs provide approximately 96,000 medical transports of Medi5 Cal beneficiaries each year. Medi-Cal pays approximately 20% of the actual cost of

6 each of these transports, forcing Plaintiffs to subsidize the government's program with

7 tens ofmillions of dollars of their private funds each year.

8

4. Plaintiffs bring this action to enjoin Defendants from enforcing Section

9 51527 of the California Code of Regulations until Defendants set Medi-Cal

10 reimbursement rates for medical transportation services providers in compliance with

11 federallaw.

12

5. Because California's policy is that medical transportation services will be

13 reimbursed "at the lesser of usual charges or the limits specified in the California code

14 of Regulations," and because Section 51527 was not promulgated in compliance with

15 federal law, or the State's certification that it would follow federal law when

16 promulgating and enforcing rate regulations, Plaintiffs also seek a permanent

17 injunction prohibiting Defendants from reimbursing Plaintiffs less than their "usual

18 charges" for the services they provide to Defendants' Medi-Cal beneficiaries until

19 Defendants comply with federal law and their own regulations.

20

6. Plaintiffs also seek declaratory and injunctive relief to enforce their

21 property rights, procedural and substantive due process rights and their rights to equal

22 protection guaranteed by the United States Constitution, and damages pursuant to 42

23 U.S.C. 1983 for these violations of Plaintiffs' Constitutional rights.

24

25

PARTIES

26

7. Plaintiff Sierra Medical Services Alliance ("SEMSA") is a 501c(3) non-

27 profit organization. SEMSA is the exclusive provider of ambulance services for

28 emergency (911) and non-emergency calls in Lassen County, California. SEMSA's

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COMPLAINT

Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 4 of 33 Page ID #:4

I franchise provider agreement was awarded through a competitive bid process in 2005

2 and its contract is effective through 2015, plus any additional earned extensions.

3 SEMSA's service rates are set and regulated by the County of Lassen.

4

8. Plaintiff Care Flight is a division of Regional Emergency Medical

5 Services Authority, a 501c(3) non-profit organization affiliated with SEMSA. Care

6 Flight provides emergency medical helicopter services in northern California and

7 northern Nevada. Care Flight operates through provider agreements with regional

8 emergency medical services agencies, including Sierra Sacramento Valley EMSA.

9

9. Plaintiff Riggs Ambulance Service, Inc., is the exclusive provider of

10 ambulance services for emergency (911) and non-emergency calls in Merced County.

11 Riggs Ambulance Service's franchise provider agreement was awarded through a

12 competitive bid process in 2003 and its contract is effective through 2012. Riggs

13 Ambulance Service rates are set and regulated through the County of Merced.

14

10. Plaintiff Schaefer Ambulance Service Inc. serves six of the most

15 populous counties in southern California including Los Angeles, Orange, San Diego,

16 San Bernardino, Riverside, and Imperial. Schaefer Ambulance has emergency (911)

17 contracts in Los Angeles and Imperial Counties. Schaefer provides a significant

18 amount of non-emergency medical transportation in Orange, San Diego, San

19 Bernardino and Riverside counties. Schaefer is engaged in a number of pilot

20 programs including critical care programs in Los Angeles County and neonatal infant

21 transportation programs in Los Angeles, Riverside, and San Bernardino counties.

22 Schaefer serves approximately 15 million people living in approximately 13,600

23 square miles of service area.

24

11. Plaintiff C.H.L. EMS, Incorporated, dba American Ambulance of

25 Visalia, provides emergency (911) and non-emergency medical transportation services

26 in a shared exclusive operating area. C.H.L. operates pursuant to an agreement with

27 the County ofTulare that runs from March 1, 2009 to June 30, 2014.

28

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COMPLAINT

Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 5 of 33 Page ID #:5

I

12. Plaintiff Desert Ambulance Service, Inc., is designated as an exclusive

2 provider of emergency (911) and non-emergency medical transportation services

3 pursuant to an agreement with San Bernardino County. Desert Ambulance's service

4 area is designated as an exclusive non-competitive area pursuant to Health and Safety

5 Code section 1797.224.

6

13. Plaintiff San Luis Ambulance Service, Inc., is the exclusive provider of

7 ambulance services for emergency (911) and non-emergency calls in three of the four

8 designated ambulance zones in San Luis Obispo County pursuant to a franchise

9 provider agreement that is effective into 2013.

IO

14. Plaintiff First Responder Emergency Medical Services-Sacramento, Inc.

II is a non-exclusive provider of ambulance services for emergency and non-emergency

I2 calls within the Sacramento, Placer and Yolo Counties.

13

15. Plaintiff First Responder Emergency Medical Services, Inc. operates as

I4 an exclusive provider of emergency (911) and non-emergency ambulance services in

I5 Butte County. Responder's service area is designated as an exclusive non-competitive

I6 area pursuant to Health and Safety Code section 1797.224.

I7

16. Plaintiff Imperial Ambulance, Inc. provides .emergency (911) and non-

IS emergency ambulance services in Tulare County pursuant to a contract with Tulare

I9 County that is effective through June 30, 2014. Within Tulare County, Imperial

20 Ambulance, Inc. responds primarily in the City of Porterville and the City ofLindsay.

2I When called upon, Imperial provides service to all other city and rural areas within

22 Tulare County.

23

17. Plaintiff Exeter District Ambulance operates as an exclusive provider of

24 emergency (911) and non-emergency ambulance services in the north eastern region

25 of Tulare County.

26

18. Plaintiff Sierra LifeStar, Inc., d.b.a. Lifestar Ambulance, operates as an

27 exclusive provider of emergency (911) and non-emergency ambulance services in

28 Tulare County.

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COMPLAINT

Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 6 of 33 Page ID #:6

1

19. Plaintiff Del Norte Ambulance, Inc. operates as an exclusive provider of

2 emergency (911) and non-emergency ambulance services in Del Norte County.

3

20. Plaintiff Napa Ambulance Service, Inc., dba Piner's Ambulance, operates

4 as an exclusive provider of emergency (911) and non-emergency ambulance services

5 in Tulare County. Napa's exclusive provider agreement was awarded through a

6 competitive bid process in 2001 and it is effective through 2011.

7

21. Plaintiff American Legion Post 108 Ambulance Service ("ALA") is a

8 SOle (19) non-profit corporation. ALA is the exclusive provider of ambulance

9 services for emergency (911) and non-emergency calls in Amador County pursuant to

10 a franchise provider agreement that is effective through 2013. ALA has been the sole

11 ambulance provider in Amador County since 1929. ALA is also the exclusive

12 provider of ambulance services for emergency (911) and non-emergency calls in

13 Calaveras County pursuant to a franchise provider agreement that is effective through

14 2014.

15

22. Plaintiff Progressive Ambulance, Inc, dba Liberty Ambulance, is the

16 exclusive provider for emergency (911) and non-emergency ambulance services in

17 Kern County's Operational Area #7. Liberty's franchise provider agreement was

18 awarded pursuant to Health and Safety Code section 1797.224 and is effective until

19 2019.

20

23. Plaintiff Hall Ambulance Service, Inc. is the exclusive provider for

21 emergency (911) and non-emergency ambulance services in Kern County Ambulance

22 Service Operational Areas 2, 4, 5, 8, 9 and 11. Operating Area(s) 2,4,5,8 & 9 were

23 awarded pursuant to Health and Safety Code section 1797.224. Operational Area 11

24 was awarded to Hall in 1994 through a competitive bid process.

25

24. Plaintiff City Ambulance of Eureka, Inc provides emergency (911) and

26 non-emergency ambulances in the County ofHumboldt.

27

25. Plaintiff Patterson District Ambulance is the exclusive provider of

28 ambulance services for emergency (911) and non-emergency calls within Zone #5 of

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COMPLAINT

Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 7 of 33 Page ID #:7

1 Stanislaus County. The Patterson District Ambulance franchise provider agreement

2 was established in 1992 by the County pursuant to California Health and Safety Code

3 1797.224 and remains in effect. A performance contract, required with the County, is

4 effective through 2012.

5

26. Plaintiff K.W.P.H. Enterprises, d.b.a. American. Ambulance, is the

6 exclusive provider of ambulance services for emergency (911) and non-emergency

7 calls in the Fresno County Exclusive Operating Area and the County of Kings. The

8 provider agreements for these service areas were awarded through competitive bid

9 processes.

10

27. Plaintiff Community Ambulance Services, Inc. dba CARE Ambulance is

11 the exclusive provider of ambulance services for emergency (911) and non-emergency

12 calls in Kern County Operating Area #6. CARE's franchise provider agreement was 13 awarded pursuant to Health and Safety Code section 1797.224.

14

28. Plaintiff Sierra Ambulance Service, Inc., is a 501c(3) non-profit

15 organization. Sierra Ambulance is the exclusive provider of ambulance services for
'
16 emergency (911) and non-emergency calls in eastern Madera County. Sierra has been

17 the exclusive 911 ambulance provider in eastern Madera County since 1965. It 18 operates under a California Health and Safety Code 1797.224 exclusive agreement

19 with the Central California EMS Agency.

20

29. Plaintiff Care Ambulance Service, Inc. is the exclusive 911 Emergency

21 Ambulance provider for the Orange County, California cities of Anaheim, Buena

22 Park, Costa Mesa, Cypress, Fountain Valley, Fullerton, Garden Grove, La Palma, Los

23 Alamitos, Seal Beach, and Stanton, as well as Exclusive Operating Area number six

24 (6) in Los Angeles County, California, which is comprised of the cities of Artesia,

25 Bell, Bell Gardens, Bellflower, Cerritos, Commerce, Cudahy, Hawaiian Gardens, La

26 Mirada, Lakewood, Huntington Park, Maywood, Montebello, Norwalk, Paramount,

27 Pico Rivera, Santa Fe Springs, Signal Hill, Whittier, and the unincorporated areas of

28

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COMPLAINT

Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 8 of 33 Page ID #:8

1 Florence-Graham and East Los Angeles. All franchise agreements were awarded

2 thorough a competitive bid process.

3

30. Delano Ambulance Service, Inc. is the exclusive provider of ambulance

4 services for all emergency (911) and non-emergency calls in Kern County for the 5 Exclusive Operating Area #3. Delano has an ongoing franchise agreement with the

6 County ofKern.

7

31. Plaintiff Kern Emergency Medical Transportation Corporation, dba Kern

8 Ambulance, is the exclusive provider for emergency (911) and non-emergency

9 ambulance services in Kern County's Operational Area #1. Kern Ambulance's

10 provider agreement was awarded pursuant to California Health and Safety Code

11 1797.224 and the contract is effective until 2019.

12

32. Plaintiff Manteca District Volunteer Ambulance Service, dba Manteca

13 District Ambulance Service, is a 50lc(3) non-profit corporation and is the exclusive

14 provider for emergency (911) and non-emergency ambulance services in the City of

15 Manteca and surrounding areas including parts of Tuolumne County.

16

33. Defendant California Department of Health Care Services

17 ("Department") is the designated single state agency charged with administering the

18 Medicaid program in the State of California pursuant to Title XIX, 42 U.S.C. 1396 et

19 seq., and California's State Plan Under Title XIX of the Social Security Act ("State

20 Plan.")

21

34. Defendant David Maxwell-Jolly is the duly appointed Director of the

22 Department of Health Care Services. Maxwell-Jolly and his predecessor Directors

23 . were acting under color of state authority at all times mentioned herein. Maxwell-

24 Jolly is sued only in his official capacity as Director.

25

26

MEDICAID AND STATE COUNTERPARTS

27

28

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8
COMPLAINT

Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 9 of 33 Page ID #:9

1

35. Medicaid is a federal program that provides medical care to needy

2 individuals by giving states funds to use to administer medical assistance programs.

3 (42 U.S.C. 1396, et seq.)

4

36. Participation in the Medicaid program is voluntary. However, if a state

5 chooses to participate, it is obligated to comply with all applicable federal statutes and

6 regulations. Initially, a state must submit, and have approved, a state plan for

7 Medicaid assistance that complies with the federal Medicaid statutes and the

8 regulations adopted by the Secretary of the United States Department of Health and

9 Human Services. One of the Department's divisions, The Centers for Medicare and

10 Medicaid Services, is responsible for approving or rejecting a state's plan.

11

37. A state plan specifies how a state will operate its medical assistance

12 program in compliance with federal law and provides assurances that the state will

13 administer its program "in conformity with the specific requirements of title XIX, the

14 regulations in this Chapter IV, and other applicable official issuances of the

15 Department [of Health and Human Services]." (42 C.F.R. 430.10.) To be approved,

16 it must specify which groups of people are eligible, the types and ranges of services to

17 be provided, the policy and methods to be used to establish payment rates for medical

18 service providers such as Plaintiffs', and other components of the state's proposed

19 program that are required by federal law.

20

38. If a state plan is deemed to comply with federal law, and is approved,

21 The Centers for Medicare and Medicaid Services provide federal funds to the state for

22 the operation of the state's program as described in its state plan.

23

39. California has chosen to participate in the Medicaid program. Medi-Cal

24 is the State's Medicaid program that provides benefits to poor individuals who satisfy

25 certain eligibility requirements. (California Welfare and Institutions Code, Section

26 14000, et seq.; California Code of Regulations, Title 22, Section 50000, et seq.)

27

28 '42 C.F.R. 447.201
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COMPLAINT

Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 10 of 33 Page ID #:10

1

40. California's State Plan states that, "[a]s a condition for receipt of Federal

2 funds under title XIX of the Social Security Act, the Department of Health Services

3 (Single State Agency) submits the following State plan for the medical assistance

4 program, and hereby agrees to administer the program in accordance with the

5 provisions of this State plan, the requirements of titles XI and XIX of the Act, and all

6 applicable Federal regulations and other official issuances of the Department."

7 (California State Plan, Plan Submittal Statement, page 1.) California's State Plan was

8 approved by The Centers for Medicare and Medicaid Services and California receives

9

10

CALIFORNIA'S GUARANTEE

11

OF MEDICAL TRANSPORTATION SERVICES

12

41. 42 U.S.C., Section 1396a, et seq., and 42 C.F.R., Part 430 et seq., set

13 forth the requirements a State Plan must satisfy in order to qualify for approval.

14 Defendants certified that, "[t]he plan is in operation on a Statewide basis in

15 accordance with all requirements of 42 CFR 431.50." (California State Plan, Section

16 1.3, page 8.)

17

42. Pursuant to federal requirements, a state plan must "[s]pecify that the

18 Medicaid agency will ensure necessary transportation for recipients to and from

19 providers" and "[d]escribe the methods that the agency will use to meet this

20 requirement." (42 C.F.R. 431.53.)

21

43. In order to obtain approval of its State Plan and to obtain federal funds,

22 California certified to the federal government that, "[u]nder California's Title XIX

23 State Plan, transportation of eligible recipients to and from health care services is

24 assured through a variety of methods . . . [including] the provision of medical

25 transportation as a direct benefit of the Title XIX program ... [consisting of] both

26 emergency and nonemergency medical transportation." (California State Plan Under

27 Title XIX, 3.1(c)(1) and Attachment 3.1-D.)

28

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COMPLAINT

Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 11 of 33 Page ID #:11

1

SETTING MEDI-CAL REIMBURSEMENT RATES FOR

2

MEDICAL TRANSPORTATION SERVICES

3

44. For all services provided under Medi-Cal as a Title XIX program,

4 pursuant to federal statute, Defendants must "provide such methods and procedures ..

5 . to assure that payments [to providers of services under the program] are consistent

6 with efficiency, economy, and quality of care and are sufficient to enlist enough

7 providers so that care and services are available under the plan at least to the extent

8 that such care and services are available to the general population in the geographic

9 area." (42 U.S.C. 1396a(a)(30)(A); 42 C.F.R. 447.204.) The Ninth Circuit has ruled

10 that this "requires the Department to consider the costs ofproviding services [when

11 setting reimbursement rates]." (Orthopedic Hosp. v. Belshe, 103 F.3d 1491, 1500 (9th

12 Cir. 1997).)

13

45. A state plan must "describe the policy and the methods to be used in

14 setting payment rates for each type of service included in the State's Medicaid

15 program." (42 C.F.R. 447.201.) Medical transportation services are covered in

16 Attachment 4.19-B, page I, of the State Plan:

17

[t]he policy of the State Agency is that reimbursement

18

for each of the other types of care or service listed in

19

Section 1905(af of the Act that are included in the

20

program under the plan will be at the lesser of usual

21

charges or the limits specified in the California code

'22

of Regulations ... [t]he methodology utilized by the

23

State Agency in establishing payment rates will be as

24

follows:

25

(a) The development of an evidentiary base or rate

26

study resulting in the determination of a

27

proposed rate.

28
2 Section 1905(a) is the former designation of 42 U.S.C !396d
11
COMPLAINT
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Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 12 of 33 Page ID #:12

1

(b) To the extent required by State or Federal law

2

or regulations, the presentation of the proposed

3

rate at public hearing to gather public input to

4

the rate determination process.

5

(c) The determination of a payment rate based on

6

an evidentiary base, including pertinent input

7

from the public.

8

(d) The establishment of the payment rate through

9

the State Agency's adoption of regulations

10

specifying such rate in the CCR ...

11

46. Accordingly, medical transportation services must be reimbursed at "the

12 lesser of usual charges," or at a statutory rate that is determined by the methodology 13 described above and that is based upon the actual cost of providing the service.

14

15

PUBLIC INPUT AND REGULATION ADOPTION PROCEDURES IN

16

CALIFORNIA

17

47. Pursuant to the Administrative Procedure Act, California Government

18 Code, Sections 11346, et seq., the Legislature has established basic minimum

19 procedural requirements for the adoption, amendment or repeal of administrative

20 regulations.

21

48. Pursuant to Government Code, Section 11346.4, there must be a public

22 comment period on all proposed regulations, with advance notice of at least 45 days of

23 the close of that comment period. Section 11346.5 of the Code establishes the

24 requirements for the notice of proposed regulations, which must include, inter alia, a

25 statement of the time, place and nature of proceedings for the adoption, amendment or

· 26 repeal of the regulation, reference to the authority under which the regulation is

27 promulgated, and an informative digest containing a concise and clear summary of

28

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COMPLAINT

Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 13 of 33 Page ID #:13

1 existing laws and regulations related directly to the proposed action and the effect of

2 the proposed action.

3

49. Pursuant to Government Code, Section 11349.3, the Office of

4 Administrative Law ("OAL") must review all regulations after they have been 5 subjected by the issuing agency to the notice and comment procedures, and make

6 determinations using the following criteria: Necessity, authority, clarity, consistency,

7 reference and non-duplication. The OAL may disapprove the regulations, in which 8 case it shall return them to the adopting agency with a written statement of

9 disapproval. If OAL approves the proposed regulations, then it shall forward them to

10 the Secretary for filing.

11

50. California law requires that, "[i]n order to increase public participation

12 and improve the quality of regulations, state agencies proposing to adopt regulations

13 shall, prior to publication of the notice required by Section 11346.5, involve parties

14 who would be subject to the proposed regulations in public discussions regarding

15 those proposed regulations, when the proposed regulations involve complex proposals

16 · or a large number of proposals that cannot easily be reviewed during the comment

17 period" (California Government Code, Section 279.)

18

19 IN VIOLATION OF FEDERAL LAW, DEFENDANTS HAVE SET PAYMENT

20 RATES THAT ARE NOT CONSISTENT WITH THE QUALITY OF CARE

21

REQITrnlliDBYCAL~ORMALAW

22

51. Pursuant to federal statute, Defendants must "provide such methods and

23 procedures ... to assure that payments [to providers of services under the program]

24 are consistent with ... [the] quality of care [provided to beneficiaries] ...." (42

25 U.S.C. 1396a(a)(30)(A); 42 C.P.R. 447.204.)

26

52. In order to ensure an efficient and fully responsive emergency

27 transportation system for all Californians, local jurisdictions, pursuant to California

28

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COMPLAINT

Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 14 of 33 Page ID #:14

1 law, allocate market rights to specific ambulance companies via competitive bid or 2 assigned contract.3 (California Health and Safety Code, Section 1797.224.)

3

53. Every local jurisdiction in California requires that designated service

4 providers respond to every emergency call that is received, regardless of whether the

5 patient in need of care is covered by private insurance, Medi-Cal, any other benefit

6. provider or no benefit provider.

7

54. Every county is required to follow California Emergency Medical

8 Services Authority ("EMSA") guidelines in designating the required service levels for

9 emergency medical transportation services. Local Emergency Medical Services

10 Agencies (LEMSAs) submit plans evidencing their compliance with state EMSA

11 guidelines to the State of California, which must approve the plan.

12

55. Each jurisdiction mandates specific service level requirements. These

13 mandates include the requirement that the jurisdiction's service provider maintain an

14 "advanced life support" state of readiness and level of care for all emergency

15 transports. Consequently, every ambulance must have at least one paramedic, one

16 emergency medical technician and must carry equipment designed to provide

17 advanced life support to a patient.

18

56. Advanced life support is defined by California law as, ". . . special

19 services designed to provide defmitive prehospital emergency medical care, including,

20 but not limited to, cardiopulmonary resuscitation, cardiac monitoring, cardiac

21 defibrillation, advanced airway management, intravenous therapy, administration of

22 specified drugs and other medicinal preparations, and other specified techniques and

23 procedures administered by authorized personnel under the direct supervision of a

24 base hospital as part of a local EMS system at the scene of an emergency, during

25 transport to an acute care hospital, during interfacility transfer, and while in the

26 emergency department of an acute care hospital until responsibility is assumed by the

27

28 ' Assignment is limited to statutorily proscribed circumstances when a provider has been providing uninterrupted service since at least January 1, 1981.
14
COMPLAINT
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Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 15 of 33 Page ID #:15

1 emergency or other medical staff of that hospital." (California Health and Safety

2 Code, Section 1797.52.)

3

57. Advanced life support services are significantly more expensive to

4 provide than basic life support services because they require more highly trained and 5 certified personnel, a larger quantity of, and more sophisticated equipment, and a

6 significantly higher level of supervision than basic life support service.

7

58. California Code of Regulations, Section 51527, which sets the Medi-Cal

8 reimbursement rates for medical transportation services, provides payment for "BLS"

9 or basic life support transports. Section 51527 does not allow reimbursement for

10 advanced life support service, the result of which is an unfunded mandate by the

11 Defendants that Plaintiffs provide advanced life support services at no cost to

12 Defendants.

13

59. Because Plaintiffs must provide advanced life support care, despite that

14 California law prohibits reimbursement for this level of care, Section 51527 is, on its

15 face, in violation of 42 U.S.C. 1396, et seq. and 42 C.F.R. 447.204.

16

17

FIRST CLAIM FOR RELIEF

18

PERMANENTINJUNCTION

19

ARTICLE VI, CLAUSE 2, OF THE UNTIED STATES CONSTITUTION

20

PRE-EMPTION BY THE MEDICAID ACT

21

60. Paragraphs 1 through 58 are incorporated by reference as if fully set forth

22 herein.

23

61. Defendants' promulgation of Section 51527 ofthe California Code of

24 Regulations violates the Supremacy Clause of the United States Constitution because

25 it is inconsistent with federal law. Plaintiffs may sue for injunctive relief directly

26 under the Supremacy Clause. Indep. Living Ctr. of S. Cal., Inc. v. Shewry, 543 F.3d

27 1050 (9th Cir. Cal. 2008).

28

I0473422v.I

15
COMPLAINT

Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 16 of 33 Page ID #:16

1

62. Defendants have never developed an evidentiary base or rate study

2 concerning medical transportation services costs that resulted in the determination of a

3 proposed rate, a violation of 42 U.S.C. 1396a(a)(30)(A) and 42 C.F.R. 447.204.

4

63. Defendants have never presented proposed rates regarding medical

5 transportation services at a public hearing to gather public input about rate

6 determination despite the complexity of the medical transportation services industry

7 and the costs associated with operating such services in a wide range of geographic

8 locations and under a wide range of conditions, in violation of 42 U.S.C.

9 1396a(a)(30)(A) and 42 C.F.R. 447.204.

10

64. Defendants have never made a determination ofpayment rates for

11 medical transportation services based on an evidentiary base which included pertinent

12 input from the public. Instead, Defendants unilaterally set payment rates for medical

13 transportation services and codified those rates at Section 51527 ofthe California

14 Code of Regulations, in violation of 42 U.S.C. 1396a(a)(30)(A) and 42 C.F.R.

15 447.204.

16

65. Defendants have never considered whether the payment rates for medical

17 transportation services at Section 51527 of the California Code of Regulations are

18 consistent with efficiency, economy or quality of care, in violation of 42 U.S.C.

19 1396a(a)(30)(A) and 42 C.F.R. 447.204.

20

66. Plaintiffs are currently suffering irreparable injury because they must,

21 pursuant to California law, continue to transport Medi-Cal recipients at a significant

22 financial loss. Plaintiffs are required to accept payment rates illegally established by

23 Defendants and cannot pursue additional payments from Defendants' beneficiaries.

24 Plaintiff's are being injured because Defendants have failed to, and refuse to comply

25 with federal law, including 42 U.S.C. 1396a(a)(30)(A) and 42 C.F.R. 447.204.

26

67. Plaintiffs' legal remedies are inadequate because until enforcement of

27 Section 51527 of the California Code of Regulations is enjoined, and Defendants set

28 reimbursement rates according to federal law, Plaintiffs will continue to suffer a

10473422v.l

16
COMPLAINT

Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 17 of 33 Page ID #:17

1 financial loss for every Medi-Cal patient they transport. Even if Plaintiffs could

2 obtain a money judgment against Defendants, the current illegal reimbursement

3 scheme would still be in effect thereafter, resulting in a continuing injury that would

4 require a new lawsuit every time a Medi-Cal recipient is transported and one of the

5 Plaintiffs is reimbursed at a rate that violates 42 U.S.C. 1396a(a)(30)(A) and 42

6 C.F.R. 447.204.

7

8

SECOND CLAIM FOR RELIEF

9

TAKING PRIVATE PROPERTY FOR PUBLIC USE

10

WITHOUT JUST COMPENSATION

11

FIFTH AMENDMENT TO THE UNITED STATES CONSTITUTION,

12

42 u.s.c. § 1983

13

68. Paragraphs 1 through 66 are incorporated by reference as if fully set forth

14 herein.

15

69. Plaintiffs do not base this claim for relief on 42 U.S.C. 1396a (a)(30)(A).

16

70. The Fifth Amendment to the United States Constitution prohibits the

17 government from taking private property for public use without just compensation.

18

71. "Every person who, under color [oflaw] ... subjects, or causes to be

19 subjected, any citizen of the United States ... to the deprivation of any rights,

20 privileges, or immunities secured by the Constitution and laws, shall be liable to the

21 party injured in an action at law, suit in equity, or other proper proceeding for

22 redress." 42 U.S.C. 1983. This statute furnishes a cause of action for the violation of

23 federal rights created by the Constitution. Chapman v. Houston Welfare Rights Org.,
24 441 u.s. 600, 617, (1979).

25

72. California law requires Plaintiffs to respond to all emergency calls and

26 provide emergency treatment and transportation to anyone who requests assistance.

27 The requirement that Plaintiffs must serve any Medi-Cal participant who requests

28 assistance, and Defendants' reimbursement at an amount that is on average, 80%

10473422v.l

17
COMPLAINT

Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 18 of 33 Page ID #:18

1 below Plaintiffs actual cost ofproviding the service, amounts to an appropriation of

2 Plaintiffs' business by Defendants. Defendants hold all bargaining power in regard to

3 Plaintiffs' provision of services to Medi-Cal recipients and have used that power to

4 consciously set ridiculously low reimbursement rates. Consequently, Plaintiffs are

5 forced to provide services to Medi-Cal recipients and pay for those services in

6 violation of their civil rights.

7

73. Moreover, under federal and state law, Plaintiffs are limited to the Medi-

8 Cal payment as payment-in-full and may not bill a patient for the amount of a shortfall

9 when the patient being transported is a Medicaid patient. The Department's payment

10 is the maximum amount Plaintiffs can recover for their services.

11 ·

74. Plaintiffs do not receive just compensation from Defendants for

12 transportation of Defendants' Medi-Cal beneficiaries. Because Medi"Cal rates for

13 medical transportation are substantially below the actual cost of providing the

14 transport service, and because Defendants know that Plaintiffs must provide service to

15 their beneficiaries, Defendants are forcing Plaintiffs to provide their services to the

16 State of California at a significant and ongoing loss. Consequently, Plaintiffs are

17 being compelled to subsidize Medi-Cal with their private funds. This action on the

18 part of the Defendants amounts to the taking of Plaintiffs' private property for public

19 use without just compensation, in violation of Plaintiffs' civil rights.

20

21

THIRD CLAIM FOR RELIEF

22

VIOLATION OF PROCEDURAL DUE PROCESS

23

FIFTH AMENDMENT TO THE UNITED STATES CONSTITUTION,

24

42 u.s.c. § 1983

25

75. Paragraphs I through 73 are incorporated by reference as if fully set forth

26 herein.

27

76. Plaintiffs do not base this claim for relief on 42 U.S.C. 1396a (a)(30)(A).

28

!0473422vJ

18
COMPLAINT

Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 19 of 33 Page ID #:19

1

77. The Fifth Amendment requires reasonable notice and opportunity to be

2 heard before the government deprives a person of a property interest. Plaintiffs have a

3 significant property interest in the money they spend and the resources they deplete

4 transporting and treating Medi-Cal recipients. Defendants reimburse Plaintiffs only a

5 small portion of the cost of providing these services to their beneficiaries and prohibit

6 them from obtaining any additional reimbursement.

7

78. The State Plan requires that notice and a hearing take place before

8 reimbursement rates are set forth under the California Code of Regulations.

9 Attachment 4.19-B of the State Plan requires "presentation of proposed rates at public

10 hearing to gather public input to the rate determination process" before rates are

11 established through the enactment of regulations. (Attachment 4.19-B, pg. 1.)

12

79. California Government Code, Section 11346.4, requires that notice be

13 given of proposed regulations "prior to the hearing and close of the public comment

14 period on the adoption, amendment or repeal of a regulation" to various groups. One

15 group which must be provided with this notice is "[a] representative number of small

16 businesses ... that are likely to be affected by the proposed action." (California

17 Government Code, Section 11346.4(a)(3).)

18

80. The Code also provides that notice of proposed adoption, amendment or

19 repeal of a regulation must be provided, and that it must include various items of

20 information, including whether and to what extent the proposed regulation will have

21 an adverse economic impact directly affecting statewide business. (California

22 Government Code, Section 11346.5.)

23

81. Defendants have failed to comply with either the State Plan or any of the

24 state or federal regulations requiring notice and a hearing for proposed regulations

25 regarding Medi-Cal reimbursement rates for medical transportation services.

26

82. Plaintiffs have not been provided with any form of notice or hearing

27 regarding the setting of reimbursement rates codified in California Code of

28 Regulations, Section 51527.

l0473422v.l

19
COMPLAINT

Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 20 of 33 Page ID #:20

1

83. Without being provided with notice or a hearing, Plaintiffs have been

2 denied their property interest in money and resources they are forced to expend

3 transporting and treating Medi-Cal patients at a financial loss, a violation of Plaintiffs'

4 civil rights.

5

6

FOURTH CLAIM FOR RELIEF

7

VIOLATION OF EQUAL PROTECTION

8

FOURTEENTH AMENDMENT TO THE U.S. CONSTITUTION,

9

42 u.s.c. § 1983

10

84. Paragraphs 1 through 82 are incorporated by reference as if fully set forth

11 herein.

12

85. Plaintiffs do not base this claim for relief on 42 U.S.C. 1396a (a)(30)(A).

13

86. Under the State Plan, a wide range of medical services are provided to

14 Medi-Cal beneficiaries. Medical transportation is assured under the State Plan (State

15 Plan, Section 3.1(c)(1) and Attachment 3.1-D) and the state plan must "[d]escribe the

16 policy and the methods to be used in setting payment rates for each type of service

17 included in the State's Medicaid program." (42 C.F.R. Section 447.201.)

18

87. The State Plan provides specific reimbursement methods to be used for

19 medical transportation services (State Plan, Attachment 4.19-B), and for other types of

20 services. For example, specific methodology for determining reimbursement rates is

21 provided for durable medical equipment (Attachment 4.19-B, page 3a), Targeted Case

22 Management Services (Attachment 4.19-B, page 5a), Federally Qualified Health

23 Centers and Rural Health Clinics (Attachment 4.19-B, page 6), Drug Medical services

24 (Attachment 4.19-B, page 38), and numerous other medical services (see Attachment

25 4.19-B).

26

88. On information and belief, Plaintiffs allege that Defendants have

27 complied with federal laws when setting Medi-Cal reimbursement rates for providers

28 other than medical transportation services providers.

10473422v.l

20
COMPLAINT

Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 21 of 33 Page ID #:21

1

89. There is no legitimate state end served by Defendants' compliance with

2 the requirements of 42 C.F.R. 447.201 (requiring State plan to set forth policy and

3 methods used in setting payment rates) for certain services and their refusal to comply

4 with it for medical transportation services. Non-emergency service providers can

5 negotiate payment rates with Defendants because they can choose not to participate in

6 Defendants' program. Defendants are aware that because of the emergency nature of

7 their work and the statutory provisions designed to assist all persons in need of

8 emergency assistance, Plaintiffs carmot choose to decline participation.

9

90. Defendants' refusal to comply with federal or state law when setting

10 reimbursement rates for medical transportation services providers does not rationally

11 relate to any public purpose. The refusal is contrary to 42 U.S.C. 1396 et seq., which

12 requires Defendants to provide medical transportation services to Medi-Cal recipients

13 and to reimburse the providers of those services pursuant to a fair process that takes

14 into consideration the actual cost of providing the services. Defendants' failure places

15 all Californians at risk by weakening the medical transportation services industry as a

16 whole by forcing Plaintiffs to subsidize Medi-Cal with their private funds which

17 causes service providers to cut back on personnel, training, equipment and innovation

18 to cut costs and avoid going out of business. Defendants' actions are reducing the

19 overall quality of care that all Californians receive.

20

91. At a minimum, under the State Plan, reimbursement rates must be

21 determined by following the four-step process set forth in Attachment 4,19-B to the

22 State Plan. Defendants have failed to follow these steps in determining

23 reimbursement rates for Plaintiffs. However, several types of medical services are

24 afforded the required processes under the State Plan .for determination of their

25 reimbursement rates. The distinctions drawn in the Department's application of state

26 and federal law bear no rational relationship to any legitimate state end.

· 27

92. Consequently, Plaintiffs are not afforded the same or similar protection

28 under the law as other Medi-Cal service providers, in violation of their civil rights.

l 0473422v.l

21
COMPLAINT

Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 22 of 33 Page ID #:22

1

2

FIFTH CLAIM FOR RELIEF

3

VIOLATION OF SUBSTANTIVE DUE PROCESS

4

FOURTEENTH AMENDMENT TO THE U.S. CONSTITUTION,

5

42 u.s.c. § 1983

6

93. Paragraphs 1 through 91 are incorporated by reference as if fully set forth

7 herein.

8

94. Plaintiffs do not base this claim for relief on 42 U.S.C. 1396a (a)(30)(A).

9

95. Defendants' action of promulgating Section 51527 is arbitrary and

10 capricious conduct that shocks the conscience because Defendants refuse to comply

11 with promises they made in exchange for receiving federal money that was intended

12 by the federal government to be paid to Plaintiffs for the services they rendered to

13 Medi-Cal beneficiaries; because Defendants use unilateral bargaining power to force

14 Plaintiffs to provide service to Medi-Cal; because Defendants, in violation of federal

15 and state law, unilaterally set the rates at which Plaintiffs are reimbursed at a

16 ridiculously low level; because despite the fact that Defendants themselves developed

17 and submitted their rate setting procedures to the federal government to obtain

18 approval oftheir State Plan, Defendants have never, and continue to refuse to follow

19 their own procedures to establish fair reimbursement rates for the services provided by

20 Plaintiffs.

21

96. Moreover, Defendants' conduct is arbitrary and capricious conduct that

22 shocks the conscience because there is no relation whatever of Defendants'

23 reimbursement rates to the costs incurred by Plaintiffs to provide the service, and in

24 fact, Defendants reimburse Plaintiffs at a rate that is approximately 20% of the actual

25 cost of providing the service to Defendants' beneficiaries, The issue is not one of lost

26 profits, but rather it is cash out-of-pocket for each transport of Defendant's Medi-Cal

27 beneficiaries that is being compelled by Defendants.

28

10473422v.l

22
COMPLAINT

Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 23 of 33 Page ID #:23

1

97. Additionally, Defendants' conduct is arbitrary and capricious conduct

2 that shocks the conscience because Defendants are aware that Plaintiffs have no

3 bargaining power, in that Plaintiffs cannot decline to participate in Plaintiffs Medi-

4 Cal program because of the emergency nature ofthe work Plaintiffs perform.

5 Defendants, as an organization of a government entity, use this unfair advantage to

6 deprive Plaintiffs of their rights by forcing them to subsidize their public assistance

7 program.

8

98. Plaintiffs' constitutionally protected property and due process rights· have

9 been, and continue to be adversely affected by Defendants' arbitrary, capricious and

10 shocking conduct.

11

99. There is no legitimate public interest served by Defendants' refusal to

12 follow the required procedures to determine reimbursement rates for medical

13 transportation services, particularly in light of the fact that Defendants themselves

14 initially developed the procedures as a way to provide a service to the public.

15 Defendants' failure to comply with their own procedures and federal law harms all

16 Californians because it weakens the entire medical transportation services industry by

17 forcing providers to shift funds away from innovation and improvements to subsidize

18 Defendants' program. Simply put, Defendants' failure reduces the overall quality of

19 medical transportation services that all Californians receive.

20

100. Consequently, Plaintiffs have been denied their right to substantive due

21 process.

22

23

PRAYER

24

Plaintiffs pray for:

25

l. An order:

26

A. Permanently enjoining Defendants and their employees, designees,

27

agents, and all other persons or entities in active concert or privity

28

or participation with them from enforcing Section 51527 of the

10473422v.l

23
COMPLAINT

Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 24 of 33 Page ID #:24

1

California Code of Regulations until Defendants set Medi-Cal

2

reimbursement rates for medical transportation services providers

3

in compliance with 42 U.S.C. 1396a(a)(30)(A) and 42 C.F.R.

4

447.204 as specified in Attachment 4.19-B, page 1, of the

5

State Plan; and

6

B. Permanently enjoining Defendants and their employees, designees,

7

agents, and all other persons or entities in active concert or privity

8

or participation with them from reimbursing Plaintiffs less than

9

their "usual charges" for the services they provide to

10

Defendants' Medi-Cal beneficiaries until Defendants set Medi-Cal

11

reimbursement rates for medical transportation services providers

12 .

in compliance with 42 U.S.C. 1396a(a)(30)(A) and 42 C.F.R.

13

447.204 as specified in Attachment 4.19-B, page 1, of the State

14

Plan·,

15

2. Declaratory relief consistent with the injunction;

16

3. Damages pursuant to 42 U.S.C. § 1983 in an amount to be ascertained;

17

4. Attorney fees and costs pursuant to 42 U.S.C. § 1988;

18

5. Costs of suit and interest;

19

6. Any other relief the Court may deem proper and equitable.

20 21 Dated: June 3, 2010 22
23
24
25

HAWKINS PARNELL THACKSTON & YOUNG LLP Edward R. Ulloa Kevin R. W rren
By: _______________________ Kevin R. Warren Attorneys for Plaintiffs

26

27
. 28

!0473422v.l

24
COMPLAINT

Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 25 of 33 Page ID #:25

1

DEMAND FOR JURY TRIAL

2

Plaintiffs hereby demand a trial by jury.

3

4 Dated: June 3, 2010 5 6 7 8

IIAWKINS PARNELL THACKSTON & YOUNG LLP Edward R. Ullo KevinR. W
By: __K~eLvi~n-R-.-W-a-rr-e-n----------­
Attorneys for Plaintiffs

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

10473422v.l

25
COMPLAINT

Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 26 of 33 Page ID #:26
UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA
NOTICE OF ASSIGNMENT TO UNITED STATES MAGISTRATE JUDGE FOR DISCOVERY
This case has been assigned to District Judge Ronald S. W. Lew and the assigned discovery Magistrate Judge is Charles Eick. The case number on all documents filed with the Court should read as follows:
CVlO- 4182 RSWL (Ex)
Pursuant to General Order 05-07 of the United States District Court for the Central District of California, the Magistrate Judge has been designated to hear discovery related motions.
All discovery related motions should be noticed on the calendar of the Magistrate Judge

NOTICE TO COUNSEL

A copy of this notice must be served with the summons and complaint on all defendants (if a removal action is filed, a copy of this notice must be served on all plaintiffs).

Subsequent documents must be filed at the following location:

[X] Western Division
312 N. Spring St., Rm. G-8
Los Angeles, CA 90012

U Southern Division

U Eastern Division

411 West Fourth St., Rm. 1-053

3470 Twelfth St., Rm. 134

Santa Ana, CA 92701-4516

Riverside, CA 92501

Failure to file at the proper location will result in your documents being returned to you.

CV-18 (03106)

NOTICE OF ASSIGNMENT TO UNITED STATES MAGISTRATE JUDGE FOR DISCOVERY

Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 27 of 33 Page ID #:27

t

Name & Address:
Edward R. Ulloa (SBN 177909) Kevin R. Warren (SBN 242238) HAWKINS PARNELL THACKSTON & YOUNG LLP 444 S. Flower Street. Suite 1100 Los Angeles. CA 90071 (213) 486-8000 Fax (213) 486-8000

0

UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA

(.) ~~~~~---------

Sierra Medical Services Alliances, et al.,

CASE NUMBER

PLAINTIFF(S)
v.
David Maxwell-Jolly, Director of the Department of Health Care Services, State of California, California Department ofHealth Care Services,
DEFENDANT(S).

SUMMONS

TO: DEFENDANT(S): David Maxwell-Jolly, Director of the Department of Health Care Services, State of California, California Department of Health Care Services

A lawsuit has been filed against you.

Within 2.\ days after service ofthis summons on you (not counting the day you received it), you

must serve on the plaintiff an answer to the attached fi"complaint 0

amended complaint

0 counterclaim 0 cross-claim or a motion under Rule 12 ofthe Federal Rules of Civil Procedure. The answer

or motion must be served on the plaintiff's attorney, Edward R. Ulloa 444 S. Flower Street, Suite 1100, Los Angeles, CA 90071

, whose address is . If you fail to do so,

judgment by default will be entered against you for the relief demanded in the complaint. You also must file

your answer or motion with the court.

-4JUN2111JJ
Dated: _ _ _ _ _ _ _ _ _ __

Clerk, U.S. District Court

[Use 60 days if the defondant is the United States or a United States agency, or is an officer or employee ofthe United States. Allowed
60 days by Rule 12(a)(3)}.

CV-OIA (12/07)

SUMMONS

Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 28 of 33 Page ID #:28

I Edward R. Ulloa (SBN 177909) eulloa(a),hptylaw. com
2 Kevin lt Warren (SBN 242238)
kwarren@hptylaw.com
3 MEMBERS OF:
HAWKINS PARNELL THACKSTON & YOUNG LLP 4 444 South Flower Street, Suite 1100
Los Angeles, CA 90071 5 Telephone: (213) 486-8000
Facs1mile: (213) 486-8080
6
Attorneys for Plaintiffs
7

8

THE UNITED STATES DISTRICT COURT FOR THE

9

CENTRAL DISTRICT OF CALIFORNIA

IO

II SIERRA MEDICAL SERVICES ALLIANCE, CARE FLIGHT, RIGGS
I2 AMBULANCE SERVICE INC. SCHAEFER AMBULANCE SERVICE,
13 INC~ AMERICAN AMBULANCE OF VISALIA, DESERT AMBULANCE
I4 SERVICE, SAN LUIS AMBULANCE SERVICE, INC:.~ f,IRST RESPONDER
I5 EMERGENCY lYmDICAL SERVICESSACRAMENTO, INC., FIRST
I6 RESPONDER EMERGENCY MEDICAL SERVICES, INC., IMPERIAL
I7 AMBULANCE SERVICES, INC., EXETER DISTRICT AMBULANCE SIERRA
I8 LIFESTAR, INC;.;. d.b.a, LIFESTAR AMBULANCE, uEL NORTE
I9 AMBULANCE, INC., PINER'S AMBULANCE, INC., AMERICAN
20 LEGION POST 108 AMBULANCE SERVICE, PROGRESSIVE AMBULANCE,
2I INC.>.d.b.a., LIBERTY AMBULANCE, 22 CHIATLYLAAMMBBUULLAANNCCEEOSFEERUVRICEEK, AIN1£1.'1\jC.,
PATTERSONDISTRICT AMBULANCE, 23 K.W.P.H. ENTERPIRSES, d.b.a.,
AMERICAN AMBULANCE 24 COMMUNITY AMBULANCE SERVICES,
INC., SIERRA AMBULANCE SERVICE, 25 INC., CARE AMBULANCE SERVICE
INC., DELANO AMBULANCE SERVICE,
2 L ~~·t-!ffiRN-EMERGENCYMEDICAL
.. T.KANSPORTATION CORPORATION_, 27 d.b.a., KERN AMBULANCE, MANTEcA
DISTRICT VOLUNTEER AMBULANCE ·-~8 -SERVICF,obam:NTECA.DISTRICT ....
n

Case No.
COMPLAINT FOR INJUNCTIVE RELIEF, DECLARATORY RELIEF AND DAMAGES; DEMAND FOR JURY
TRIAL

----~~-~-·-~---~-~~=~~~---
I

!0473422v.l

Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 29 of 33 Page ID #:29

1 AMBULANCE SERVICE,

2
3
vs.
4

Plaintiffs,

5 DAVID MAXWELL-JOLLY, Director of the Department of Health Care Services, State of
6 California, CALIFORNIA DEPARMENT OF HEALTH CARE SERVICES,
7
Defendants.
8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23 !

24

25

26

27

28

Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 30 of 33 Page ID #:30

UNITED STATES DISTRICT COURT, CENTRAL DISTRICT OF CALIFORNIA
CIVIL COVER SHEET
..

I (a) PLAINTIFFS (Check box ifyou are representing yourself D) Sierra Medical Services Alliance, Care Flight, Riggs Ambulance Service, Inc.,
Schaefer Ambulance Service, Inc., American Ambulance of Visalia, Desert Ambulance Service, San Luis Ambulance Service, Inc.,

...
DEFENDANTS David Maxwell-Jolly, Director of the Department of Health Care Services, State
of California, California Department of Health Care Services

Continued on Attachment A

(b) Attorneys (Finn Name, Address and Telephone Number. Ifyou are representing yourself, provide same.)
Edward R UJioa (SBN 177909), Kevin R. Warren (SBN 242238} Hawkins Parnell Thackston & Young LLP
444 S. Flower Street, Suite 1100, Los Angeles, California 90071

Attorneys (If Known)

II. BASIS OF .JURISDICfiON (Place an X in one box only.)

0 I U.S. Government Plaintiff

~3 Federal Question (U.S.
Government Not a Party)

IlL CITIZENSHIP OF PRINCIPAL PARTIES- For Diversity Cases Only (Place an X in one box for plaintiff and one for defendant)

Citizen ofThis State

PTF DEF 01 01 Incorporated or Principal Place
ofBusiness in this State

PTF DEF 04 04

0 2 U.S. Government Defendant 0 4 Diversity (Indicate Citizenship Citizen ofAnother State
of Parties in Item liD

02 02 Incorporated and Principal Place 05 05 of Business in Another State

Citizen or Subject of a Foreign CountJy 0 3 0 3 Foreign Nation

06 06

IV. ORIGIN (Place an X in one box only.)

ilf1 Original

0 2 Removed from 0 3 Remanded from

Proceeding

State Court

Appellate Court

0 4 Reinstated or Reopened

0 5 Transferred from another district {specifY):

0 6 Multi- 0 7 Appeal to District

District

Judge from

Litigation

Magistrate Judge

V. REQUESTED IN COMPLAINT: JURY DEMAND: fives 0 No (Check 'Yes' only ifdemanded in complaint)

CLASS ACTION under F.R.C.P. 23: 0 Yes Ii"No

MMONEY DEMANDED IN COMPLAINT: S to be ascertained

VL ·CAUSE OF ACfiON (Cite the U.S. Civil Statute under which you are filing and write a brief statement ofcause. Do not cite jurisdictional statutes-unless diversity.) Tilegal Medi-Cal rate statute, Supremacy Clause of U.S. Const, 42 U.S.C. 1395 et seq., 42 U.S.C. 1396, et seq., 42 U.S.C. 1983, Fifth Am., Fourteenth Am.
Vll. NATURE OF SUI'.f{Piace an X in one·box only.)

0410 Antitrust 0430 Banks and Banking 0450 CommerceJICC
Rates/etc. 0460 Deportation 0470 Racketeer Influenced
and Corrupt Organizations 0 480 Consumer Credit 0 490 Cable/Sat TV 0 810 Selective Service 0 850
Exchange 0 875 Customer Challenge 12
USC3410 0890 Other StatutoryActions 0 891 Agricultural Act 0892 Economic Stabilization
Act 0893 Environmental Matters 0894 Energy Allocation Act 0895 Freedom of Info. Act 0900 Appeal ofFee Detenni-
nation Under Equal Access to Justice M95o Constitutionality of
State Statutes

Miller Act Negotiable Instrument Recovery of Overpayment & Enforcement of Judgment Medicare Act Recovery of Defaulted Student Loan (Excl. Veterans) Recovery of Overpayment of Veteran's Benefits Stockholders' Suits Other Contract Contract Product Liability
Foreclosure Rent Lease& Torts to Land Tort Product Liability All Other Real Property

Airplane Product Liability Assault, Libel & Slander Fed. Employers' Liability Marine Marine Product Liability Motor Vehicle Motor Vehicle Product Liability Other Personal Injury Personal InjuryMed Malpractice Personal InjuryProduct Liability Asbestos Personal
Product

Welfare American with Disabilities Employment American with DisabilitiesOther Other Civil Rights

Labor/Mgmt. Relations Labor/Mgmt. Reporting & Disclosure Act Railway Labor Act Other Labor
Drug Drug Related Seizure of Property 21 USC 881 Liquor Laws RR&Truck Airline Regs Occupational Safety /Health Othe'

FOR OFFICE USE ONLY: Case Ntunber: - - - - - - - - - - - - - - - - - - - - - - - - - - · AFTER COMPLETING ffiE FRONT SIDE OF FORM CV-71, COMPLETE THE INFORMATION REQUESTED BELOW.

CV-71 (05/08)

CIVIL COVER SHEET

Page I of2

Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 31 of 33 Page ID #:31
UNITED STATES DISTRICT COURT, CENTRAL DISTRICT OF CALIFORNIA
CIVIL COVER SHEET

VIII(a). IDENTICAL CASES: Has this action been previously flied in this court and dismissed, remanded or closed? fi'No 0 Yes Ifyes,listcasenumber(s): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ VIII(b). RELATED CASES: Have any cases been previously filed in this court that are related to the present case? ri'No 0 Yes Ifyes,listcasenwnber(s): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Civil cases are deemed related ifa previously flied case and the present case:
(Check all boxes that apply) D A Arise from the same or closely related transactions, happenings, or events; or
0 B. Call for determination of the same or substantially related or similar questions of law and fact; or 0 C. For other reasons would entail substantial duplication oflabor if heard by different judges; or
D D. Involve the same patent, trademark or copyright, .!!lli! one of the factors identified above in a, b or c also is present.

IX. VENUE: (When completing the following information, use an additional sheet if necessary.)

(a) List the County in this District; California County outside of this District; State ifother than California; or Foreign Country, in which EACH named plaintiff resides. 0 Check here if the ~>"ovemment, its a~'"encies or emnlovees is a named olaintiff. If this box is checked, go to item (b).

County in this District:*

California County outside of this District; State, if other than California; or Foreign Country

Los Angeles, Onmge, San Bernardino, Riverside, San Luis Obispo

See Attachment A

(b) List the County in this District; California County outside of this District; State if other than California; or Foreign Country, in which EACH named defendant resides. 0 Check here ifthe e:ovemment, its ae:encies or emolovees is a named defendant. If this box iS checked, e:o to item (c).

County in this District:*

California County outside of this District; State, if other than California; or Foreign Country

Los Angeles

Sacramento

(c) List the County in this District; California County outside of this District; State if other than California; or Foreign Country, in which EACH claim arose. Note: In Iand condemnaf100 cases, use tbe locationoftbe traet ofland involved

County in this District:*

California County outside of this District; State, if other than California; or Foreign Country

Los Angeles, Orange, San Bernardino, Riverside, San Luis Obispo

Lassen, Placer, Merced, Imperial, San Diego, Tulare, Yolo, Butte, Del Norte, Amador, Calaveras, Kern, Humboldt, Stanislaus, Fresno, Kings, Madera, San Joaquin, Tuolunme

*Los Angeles, Orange, San Bernardino, Riverside, Ventura, Santa Note: In land condemnation cases use the location ofthe tract ofl d ·

Notice to Counsel/Parties: The CV·71 (JS44) Civil Cover Sheet and the information contained herein neither replace nor supplement the filing and service ofpleadings or other papers as required by law. This form, approved by the Judicial Conference ofthe United States in September 197.4, is required pursuant to Local Rule3·1 is not filed but is used by the Clerk ofthe Court for the purpose ofstatistics, venue and initiating the civil docket sheet. (For more detailed instructions, see separate instructions sheet.)
Key to Statistical codes relating to Social Security Cases:
Nature of Suit Code Abbreviation Substantive Statement of Cause ofAction

861

HIA

All claims for health insurance benefits (Medicare) under Title 18, Part A, ofthe Social Security Act, as amended.

Also, include claims by hospitals, skilled nursing facilities, etc., for certification as providers of services under the

prognun (42 U.S.C. 1935FF(b))

862

BL

All claims for«Black Lung"" benefits under Title 4, Part B, of the Federal Coal Mine Health and Safety Act of 1969.

(30 U.S.C. 923)

863

DIWC

All claims fLied by insured workers for disability insurance benefits under Title 2 ofthe Social Security Act, as

amended; plus all claims filed for child's insurance benefits based on disability. (42 U.S.C. 405(g))

863

DIWW

All claims filed for widows or widowers insurance benefits based on disability under Title 2 ofthe Social Security

Act, as amended. (42 U.S.C. 405(g))

864

SSID

All claims for supplemental security income payments based upon disability filed under Title 16 of the Social Security

Act, as amended.

865

RSI

All claims for retirement (old age) and survivors benefits under Title 2 ofthe Social Security Act, as amended. (42

U.S. C. (g))

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Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 32 of 33 Page ID #:32

ATTACHMENT A
I(a) PLAINTIFFS, cont.
First Responder Emergency Medical Services-Sacramento, Inc. First Responder Emergency Medical Services, Inc. Imperial Ambulance Services, Inc. Exeter District Ambulance Sierra Lifestar, Inc., dba Lifestar Ambulance Del Norte Ambulance, Inc. Napa Ambulance Service, Inc., dba Piner's Ambulance, Inc. American Legion Post 108 Ambulance Service Progressive Ambulance, Inc., dba Liberty Ambulance Hall Ambulance Service, Inc. City Ambulance of Eureka, Inc. Patterson District Ambulance K.W.P.H. Enterprises, dba American Ambulance Community Ambulance Services, Inc. dba Care Ambulance Sierra Ambulance Service, Inc. Care Ambulance Service, Inc. Delano Ambulance Service, Inc. Kern Emergency Medical Transportation Corporation, dba Kern Ambulance Manteca District Volunteer Ambulance Service, dba Manteca District Ambulance Service
IX VENUE, cont.
PLAINTIFF
Sierra Medical Services Alliance Care Flight Riggs Ambulance Service, Inc. Schaefer Ambulance Service, Inc.
American Ambulance of Visalia Desert Ambulance Service San Luis Ambulance Service, Inc. First Responder Emergency Medical Services-Sacramento, Inc. First Responder Emergency Medical Services, Inc. Imperial Ambulance Services, Inc. Exeter District Ambulance Sierra Lifestar, Inc., dba Lifestar Ambulance Del Norte Ambulance, Inc.

COUNTY
Lassen Placer Merced Los Angeles, Orange, San Bernardino, Riverside, Imperial, San Diego Tulare San Bernardino San Luis Obispo Placer, Yolo Butte Tulare Tulare Tulare Del Norte

Case 2:10-cv-04182-CAS -MAN Document 1 Filed 06/04/10 Page 33 of 33 Page ID #:33

Napa Ambulance Service, Inc., dba Piner's Ambulance, Inc. American Legion Post 108 Ambulance Service Progressive Ambulance, Inc., dba Liberty Ambulance Hall Ambulance Service, Inc. City Ambulance of Eureka, Inc. Patterson District Ambulance K.W.P.H. Enterprises, dba American Ambulance Community Ambulance Services, Inc. dba Care Ambulance Sierra Ambulance Service, Inc. Care Ambulance Service, Inc. Delano Ambulance Service, Inc. Kern Emergency Medical Transportation Corporation,
dba Kern Ambulance Manteca District Volunteer Ambulance Service,
dba Manteca District Ambulance Service

Tulare Amador, Calaveras Kern Kern Humboldt Stanislaus Fresno, Kings Kern Madera Orange, Los Angeles Kern
Kern
San Joaquin, Tuolumne

 
 Case 2:10-cv-04182-CAS -MAN Document 19 Filed 07/07/10 Page 1 of 3 Page ID #:176

1 EDMUND G. BROWN JR. Attorney General of California
2 RICHARD T. WALDOW JENNIFER M. KIM
3 LESLIE P. MCELROY Supervising Deputy Attorneys General
4 TRACEY L. ANGELOPOULOS State Bar No. 220095
5 TARA L. NEWMAN State Bar No. 210960
6 CHARA L. CRANE Deputy Attorneys General
7 300 South Spring Street, Suite 1702 Los Angeles, CA 90013
8 Telephone: (213) 897-2451 Fax: (213) 897-2805
9 E-mail: Tracey.Angelopoulos@doj.ca.gov Attorneys for Defendant
10

11

IN THE UNITED STATES DISTRICT COURT

12

FOR THE CENTRAL DISTRICT OF CALIFORNIA

13

WESTERN DIVISION

14

15

SIERRA MEDICAL SERVICES

CV10-04182 SJO (Ex)

16 ALLIANCES, et al.,

Honorable S. James Otero

17

Plaintiffs,

NOTICE OF MOTION AND

18

v.

MOTION FOR STAY

19

Date:

August 9, 2010

DAVID MAXWELL-JOLLY,

Time:

10:00 a.m.

20 Director of the Department of Health Courtroom: 1

Care Services of the State of

21 California, CALIFORNIA

Action Filed: June 4, 2010

DEPARTMENT OF HEALTH CARE

22 SERVICES,

23

Defendants.

24

25

TO PLAINTIFFS AND THE ATTORNEYS OF RECORD:

26

PLEASE TAKE NOTICE that on August 9, 2010 at 10:00 a.m. in

27 Courtroom 1 of the above-entitled court, located at 312 N. Spring Street in Los

28 Angeles, California, Defendants David Maxwell-Jolly (the Director), Director of

1

Case 2:10-cv-04182-CAS -MAN Document 19 Filed 07/07/10 Page 2 of 3 Page ID #:177

1 the California Department of Health Care Services (the Department), and the

2 Department will, and hereby do, move for an order staying this case pending

3 resolution of the Director’s Petitions for Certiorari in the United States Supreme

4 Court in Independent Living Center of Southern California, et al. v. Shewry,

5 U.S.S.C. Case No. 09-958, (Independent Living), and California Pharmacists

6 Association, et al. v. Maxwell-Jolly, U.S.S.C. Case No. 09-1158.

7

Plaintiffs’ complaint challenges California Code of Regulations, title 22,

8 section 51527 (section 51527), which provides Medi-Cal reimbursement rates for

9 medical transportation services. Plaintiffs contend section 51527 violates the

10 Supremacy Clause because it was enacted without regard to the requirements of 42

11 U.S.C. section 1396a(a)(30)(A) (section 30(A)). However, the issue of whether

12 private parties may enforce section 30(A) through a Supremacy Clause claim is

13 currently pending before the United States Supreme Court in the Director’s Petition

14 for Certiorari in Independent Living. On May 24, 2010, the Supreme Court invited

15 the Solicitor General to file a brief in Independent Living. Defendants seek to stay

16 any new proceedings in this case while the Director’s Petition for Writ of Certiorari

17 in Independent Living is pending to preserve the resources of the Court and parties.

18

In addition, Plaintiffs have already litigated and lost the same issues

19 presented in this case in a parallel state court proceeding, Sierra Medical Services,

20 Inc., et al. v. Department of Health Care Services, et al., Los Angeles Superior

21 Court Case No. BS 114671. The state court proceeding is currently on appeal to

22 the California Court of Appeal. This matter should be stayed under the Colorado

23 River doctrine pending the outcome of the appeal. Colorado River Water

24 Conservation Dist. v. United States, 424 U.S. 800, 817, 96 S. Ct. 1236, 47 L. Ed. 2d

25 483 (1976).

26

On July 1, 2010, and in accordance with Local Rule 7-19.1, Defendants gave

27 notice to Plaintiffs’ counsel of their intent to file an ex part application for an order

28

2

Case 2:10-cv-04182-CAS -MAN Document 19 Filed 07/07/10 Page 3 of 3 Page ID #:178

1 staying the case, or in the alternative, for an order shortening time for the motion to

2 stay to be heard.

3

This Motion for a Stay is based on this Notice of Motion and Motion, the

4 Memorandum of Points and Authorities, the Declaration of Deputy Attorney

5 General Tracey L. Angelopoulos and Exhibits thereto, and all other records on file

6 with the Court in this matter.

7 Dated: July 6, 2010 8 9 10 11 12 13 14
LA2010600474
15 Document in ProLaw

Respectfully submitted, EDMUND G. BROWN JR. Attorney General of California JENNIFER M. KIM RICHARD T. WALDOW Supervising Deputy Attorneys General /s/ Tracey L. Angelopoulos TRACEY L. ANGELOPOULOS Deputy Attorney General Attorneys for Defendant

16

17

18

19

20

21

22

23

24

25

26

27

28

3

 
 Case 2:10-cv-04182-CAS -MAN Document 23 Filed 07/16/10 Page 1 of 3 Page ID #:292

UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA

Case No. Title

CIVIL MINUTES - GENERAL

CV 10-4182 CAS (Ex)

Date July 16, 2010

SIERRA MEDICAL SERVICES ALLIANCE, et al. v. DAVID MAXWELL-JOLLY, et al.

Present: The Honorable CHRISTINA A. SNYDER

CATHERINE JEANG

NOT PRESENT

N/A

Deputy Clerk

Court Reporter / Recorder

Tape No.

Attorneys Present for Plaintiffs:

Attorneys Present for Defendants:

NOT PRESENT

NOT PRESENT

Proceedings:

(In Chambers:) DEFENDANTS’ EX PARTE APPLICATION FOR A STAY, OR ALTERNATIVELY, FOR AN ORDER SHORTENING TIME ON DEFENDANTS’ MOTION TO STAY (filed 7/06/10)

I. INTRODUCTION & BACKGROUND
On June 4, 2010, plaintiffs Sierra Medical Services, et al., filed the instant action against David Maxwell-Jolly, Director of the California Department of Health Care Services (the “Director”) and the California Department of Health Care Services (the “Department”).1 The Department is a California agency charged with the administration of California’s Medicaid program, Medi-Cal. Plaintiffs provide medical transportation services to Medi-Cal beneficiaries. In the instant action, plaintiffs seek to enjoin defendants from enforcing Section 51527 of the California Code of Regulations on the grounds, among others, that these rate provisions violate 42 U.S.C. § 1396a(30)(A) of the Medicaid Act and are thus preempted under the Supremacy Clause.
On July 6, 2010, defendants filed the instant ex parte application to stay the case or, alternatively, to hear the motion for stay on shortened notice. Plaintiffs filed their opposition to the instant ex parte application on July 7, 2010.

1 On July 7, 2010, the instant case was transferred to this Court pursuant to

General Order 08-05.

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Case 2:10-cv-04182-CAS -MAN Document 23 Filed 07/16/10 Page 2 of 3 Page ID #:293

UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA

Case No. Title

CIVIL MINUTES - GENERAL

CV 10-4182 CAS (Ex)

Date July 16, 2010

SIERRA MEDICAL SERVICES ALLIANCE, et al. v. DAVID MAXWELL-JOLLY, et al.

II. LEGAL STANDARD

A district court has discretionary power to stay proceedings in its own court. See Landis v. North American Co., 299 U.S. 248, 254 (1936). Accordingly, the court "may, with propriety, find it is efficient for its own docket and the fairest course for the parties to enter a stay of an action before it, pending resolution of independent proceedings which bear upon the case." Leyva v. Certified Grocers of Cal. Ltd., 593 F.2d 857, 863 (9th Cir. 1979). However, case management concerns alone are not necessarily a sufficient ground to stay proceedings. See Dependable Highway Express v. Navigators Ins. Co., 498 F.3d 1059, 1066 (9th Cir. 2007). “‘[I]f there is even a fair possibility that the stay . . . will work damage to someone else,' the stay may be inappropriate absent a showing by the moving party of ‘hardship or inequity.’” Id. (quoting Landis, 299 U.S. at 255). Further, “being required to defend a suit, without more, does not constitute a ‘clear case of hardship or inequity’ within the meaning of Landis.” Lockyer v. Mirant Corp., 398 F.3d 1098, 1112 (9th Cir. 2005).

III. DISCUSSION

For the same reasons the Court found that good cause exists to stay the related matters of Independent Living Center of Southern California, et al. v. Sandra Shewry, Case No. 08-3315 CAS (MANx) (“Independent Living”), and the consolidated matters of California Assoc. of Health Facilities v. David Maxwell-Jolly, et al., case No. 10-3259 CAS (MANx), and Developmental Services Network, et al. v. David Maxwell-Jolly, Case No. 10-3284 CAS (MANx), recent events justify an immediate stay of the instant matter pending resolution of defendant’s petitions for certiorari in Independent Living and California Pharmacists, Ass’n v. David Maxwell-Jolly, Case No. 09-8200 (“Cal. Pharmacists”). First, on May 24, 2010, the Supreme Court invited the Solicitor General to file a brief in Independent Living. In addition, the Ninth Circuit stayed the appellate proceedings in the related matter of California Hospital Assoc. v. David Maxwell-Jolly, Case. No. 09-8642 CAS (“CHA”), in light of the pending petitions for certiorari in Independent Living and Cal. Pharmacists. One question presented in the petitions for certiorari is whether Medicaid recipients may maintain a private cause of action under the Supremacy Clause to enforce 42 U.S.C. § 1396a(a)(30)(A), which is a basis of relief in the instant case.

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Case 2:10-cv-04182-CAS -MAN Document 23 Filed 07/16/10 Page 3 of 3 Page ID #:294

UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA

Case No. Title

CIVIL MINUTES - GENERAL

CV 10-4182 CAS (Ex)

Date July 16, 2010

SIERRA MEDICAL SERVICES ALLIANCE, et al. v. DAVID MAXWELL-JOLLY, et al.

Accordingly, the Court GRANTS defendant’s ex parte application. Within 30 days from the date of this order, or upon the disposition of the petitions for certiorari, whichever occurs first, the parties shall file a joint status report. Because defendants’ Motion to Stay, filed July 6, 2010, seeks the same relief granted herein the Motion to Stay is hereby DENIED as moot.
IT IS SO ORDERED.

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 UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA

Case No. Title

CIVIL MINUTES - GENERAL

CV 10-4182 CAS (Ex)

Date July 26, 2011

SIERRA MEDICAL SERVICES ALLIANCE; ET AL. v. DAVID MAXWELL-JOLLY; ET AL.

Present: The Honorable CHRISTINA A. SNYDER

CATHERINE JEANG

Not Present

N/A

Deputy Clerk

Court Reporter / Recorder

Tape No.

Attorneys Present for Plaintiffs:

Attorneys Present for Defendants:

Not Present

Not Present

Proceedings:

(In Chambers:) PLAINTIFFS’ STATUS REPORT AND REQUEST TO LIFT STAY (filed 07/14/11)

DEFENDANTS’ EX PARTE APPLICATION FOR EXTENSION OF TIME TO FILE A RESPONSIVE PLEADING (filed 07/14/11)

I. INTRODUCTION & BACKGROUND

On June 4, 2010, plaintiffs Sierra Medical Services, et al., filed the instant action against David Maxwell-Jolly, Director of the California Department of Health Care Services (the “Director”) and the California Department of Health Care Services (the “Department”). In their complaint, plaintiffs seek to enjoin defendants from enforcing Section 51527 of the California Code of Regulations on the grounds, among others, that these rate provisions violate 42 U.S.C. § 1396a(30)(A) of the Medicaid Act (“Section 30(A)”) and are thus preempted under the Supremacy Clause.

On July 19, 2010, the Court stayed all proceedings in this action pending the United States Supreme Court’s resolution of the petitions for certiorari in Maxwell-Jolly v. Indep. Living Ctr. of S. Cal., U.S.S.C. Case No. 09-958 and Maxwell-Jolly v. Cal. Pharms. Ass’n, U.S.S.C. Case No. 09-1158. See Dkt. 23. On January 18, 2011, the Supreme Court partially granted review in Indep. Living Ctr. of S. Cal. and Cal. Pharms. Ass’n limited to the question of whether Medicaid recipients and providers may maintain a private cause of action under the Supremacy Clause to enforce Section 30(A) by asserting that the provision preempts a state law that reduces reimbursement rates. On

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UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA

Case No. Title

CIVIL MINUTES - GENERAL

CV 10-4182 CAS (Ex)

Date July 26, 2011

SIERRA MEDICAL SERVICES ALLIANCE; ET AL. v. DAVID MAXWELL-JOLLY; ET AL.

June 1, 2011, the Court issued an order removing the case from its active caseload until further application by the parties or order of the Court. See Dkt. 32.
On July 8, 2011, without seeking to lift the stay, plaintiffs attempted to file a first amended complaint. On July 13, 2011, the Clerk of the Court filed a Notice to Filer of Deficiencies in Electronically Filed Documents, noting that there was no order on the docket allowing the filing of a first amended complaint. Dkts. 36 and 37.
On July 14, 2011, plaintiffs filed a status report and request to lift stay and re-open the case. Plaintiffs assert that the proposed first amended complaint drops the claim for relief that was based on defendants’ alleged violation of the Supremacy Clause or private enforcement through Section 30(A). See Dkt. 39 at 2. Consequently, plaintiffs argue that there is no longer any basis for a stay pending resolution of the Supreme Court proceedings in Indep. Living Ctr. of S. Cal. and Cal. Pharms. Ass’n. Id.
II. DISCUSSION
The Court finds that, at this stage, plaintiffs’ proposed first amended complaint is not properly before the Court. Plaintiffs’ attempt to file an amended complaint without first moving to lift the stay was in contravention of the Court’s June 1, 2011 Order. See Dkt. 32 at 1 (“[T]his action is hereby removed from this Court’s active caseload until further application by the parties or order of this Court.”) (emphasis supplied).
Furthermore, plaintiffs’ request for an order lifting the stay must be made by a properly noticed motion to which defendants have an opportunity to respond. See Fed. R. Civ. P. 7(b)(1); Local Rule 7-4.
Finally, to the extent plaintiffs seek to lift the stay for the purpose of filing an amended complaint, plaintiffs have not obtained defendants’ consent or leave of the Court, see Fed. R. Civ. P. 15(a)(2), and it is not clear that plaintiffs may amend “as a matter of course.” See Fed. R. Civ. P. 15(a)(1) (a party may amend its pleading once as a matter of course within 21 days after serving it, or if the pleading is one to which a responsive pleading is required, 21 days after service of a responsive pleading, or 21 days after service of a motion under Rule 12(b), (e) or (f), whichever is earlier).

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UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA

Case No. Title

CIVIL MINUTES - GENERAL

CV 10-4182 CAS (Ex)

Date July 26, 2011

SIERRA MEDICAL SERVICES ALLIANCE; ET AL. v. DAVID MAXWELL-JOLLY; ET AL.

III. CONCLUSION

Accordingly, the Court hereby DENIES plaintiffs’ request to lift the stay and reopen the case without prejudice to being renewed by properly noticed motion. The Court hereby DENIES as moot defendants’ ex parte application for an order that defendants may file a responsive pleading to plaintiffs’ amended complaint within 21 days of the stay being lifted.

IT IS SO ORDERED.

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 Case 2:10-cv-04182-CAS -MAN Document 54 Filed 08/29/11 Page 1 of 5 Page ID #:811

UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA

Case No. Title

CIVIL MINUTES - GENERAL

CV 10-04182 CAS (MANx)

Date August 29, 2011

SIERRA MEDICAL SERVICES ALLIANCE; ET AL v. DAVID MAXWELL-JOLLY; ET AL.

Present: The Honorable CHRISTINA A. SNYDER, U.S. DISTRICT JUDGE

RITA SANCHEZ Deputy Clerk

LAURA ELIAS Court Reporter / Recorder

N/A Tape No.

Attorneys Present for Plaintiffs:

Attorneys Present for Defendants:

NOT PRESENT

NOT PRESENT

Proceedings:

(IN CHAMBERS) PLAINTIFF’S MOTION TO LIFT STAY AND PLACE CASE ON COURT’S ACTIVE LIST (filed 8/1/11)

I. INTRODUCTION AND BACKGROUND

On June 6, 2010, plaintiffs Sierra Medical Services Alliance, Care Flight, Riggs Ambulance Service, Inc., American Ambulance Service, Inc., Schaefer Ambulance Service, Inc., American Ambulance of Visalia, Desert Ambulance Service, San Luis Ambulance Service, Inc., First Responder Emergency Medical Services, Inc., Imperial Ambulance Services, Inc., Exeter District Ambulance, Sierra Lifestar, Inc., d.b.a. Lifestar Ambulance, Del Norte Ambulance, Inc., Piner’s Ambulance, Inc., American Legion Post 108 Ambulance Service, Progressive Ambulance, Inc., d.b.a, Liberty Ambulance, Hall Ambulance Service, Inc., City Ambulance of Eureka, Inc., Patterson District Ambulance, K.W.P.H. Enterprises, d.b.a., American Ambulance, Community Ambulance Services, Inc., Sierra Ambulance Service, Inc., Care Ambulance Service, Inc., Delano Ambulance Service, Inc., Kern Emergency Medical Transportation Corporation, d.b.a, Kern Ambulance, Manteca District Volunteer Ambulance Service, d.b.a Manteca District Ambulance Service in CV 10-04182 CAS (MANx), filed the instant action against David Maxwell-Jolly, Former Director of the California Department of Health Care Services (the “Former Director”) and the California Department of Health Care Services (the “Department”) (collectively “Defendants”). The Department is a California agency charged with the administration of California’s Medicaid program, Medi-Cal. Plaintiffs provide medical transportation services in 31 of 58 California counties.

On July 28, 2009, California Governor Arnold Schwarzenegger signed into law

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Case 2:10-cv-04182-CAS -MAN Document 54 Filed 08/29/11 Page 2 of 5 Page ID #:812
UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA

Case No. Title

CIVIL MINUTES - GENERAL

CV 10-04182 CAS (MANx)

Date August 29, 2011

SIERRA MEDICAL SERVICES ALLIANCE; ET AL v. DAVID MAXWELL-JOLLY; ET AL.

Assembly Bill X4 5 (“AB 5” ), the budget trailer bill for California fiscal year 20092010. AB 5 amends Cal. Welf. & Inst. Code § 14105.191, in part, and effectively “freezes” the Medi-Cal reimbursement rates for certain designated services rendered during the 2009-2010 rate year and each rate year thereafter at 2008-2009 levels. Cal. Welf. & Inst. Code § 14105.191(f). Among the designated services covered by AB 5 are medical transportation services.

On June 4, 2010, plaintiffs filed a motion seeking to enjoin application of the rate freeze.1 See Doc. 1. Before the hearing on plaintiffs’ motion for a preliminary
injunction, the Court stayed the case. See Doc. 23. The Court found that good cause
existed to stay the case because there was then pending before the United States Supreme
Court the Department’s petitions for certiorari in Independent Living Center of Southern
California, Inc. v. Maxwell-Jolly, U.S.S.C. Case No. 09-958 (“ILC II”), and MaxwellJolly v. California Pharmacists Ass’n (“Cal. Pharm.”), U.S.S.C. Case No. 09-1158.2

Since the stay was issued in this case, the Supreme Court has granted the Department’s petitions for certiorari. On January 18, 2011, the Supreme Court partially granted review in ILC II, limited to the question of whether Medicaid recipients and providers may maintain a private cause of action under the Supremacy Clause to enforce Section 30(A) by asserting that the provision preempts a state law that reduces

1 This Court granted a preliminary injunction in another action challenging the same rate freeze as applied to skilled nursing facilities that are distinct parts of general acute care hospitals. See Cal. Hospital Ass’n v. Maxwell-Jolly (“CHA I”), Case No. 09CV-8642, Order (C.D. Cal. Feb. 24, 2010). The Court enjoined the rate freeze on the grounds that plaintiff was likely to succeed on its claim that the freeze was enacted by the State without complying with Section 30(A).

2 Subsequent to the stay that was issued in this case, the Department filed another

petition for certiorari in Maxwell-Jolly v. Santa Rosa Mem’l Hosp. (“Santa Rosa”),

U.S.S.C. Case No. 10-283, a case concerning some of the same rate reductions at issue in

ILC II and Cal. Pharm. The petitions for certiorari in Santa Rosa and Cal. Pharm. raise

identical legal issues to those in ILC II and, consequently, the Supreme Court is

addressing them together with ILC II. The Court refers to all three cases generically as

ILC II.

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Case 2:10-cv-04182-CAS -MAN Document 54 Filed 08/29/11 Page 3 of 5 Page ID #:813
UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA

Case No. Title

CIVIL MINUTES - GENERAL

CV 10-04182 CAS (MANx)

Date August 29, 2011

SIERRA MEDICAL SERVICES ALLIANCE; ET AL v. DAVID MAXWELL-JOLLY; ET AL.

reimbursement rates. Oral argument is set for October 3, 2011.

Two related cases are also pending before the Ninth Circuit Court of Appeals. In California Ass’n of Hosp. Facilities v. Maxwell-Jolly (“CAHF”), Case No. 11-55852, and Developmental Servs. Network v. Maxwell-Jolly (“DSN”), Case No. 11-5585, the Ninth Circuit will consider whether providers can challenge State Plan Amendment approval under 42 U.S.C. § 1983 when Congress has not specifically conferred such a right on providers. CAHF and DSN have been fully briefed and are awaiting oral argument, which is set for October 11, 2011.

On August 1, 2011, plaintiffs filed the instant motion to lift the stay in this case, and lodged a proposed first amended complaint. Plaintiffs proposed first amended complaint seeks to enjoin the enforcement of California Code of Regulations, section 51527, which sets the Medi-Cal reimbursement rates for medical transportation services on the grounds that section 51527 was promulgated in violation of plaintiffs’ constitutional rights. On August 8, 2011, defendants filed an opposition. Plaintiffs replied on August 15, 2011. After carefully considering the arguments set forth by both parties, the Court finds and concludes as follows.

II. LEGAL STANDARD

A district court has discretionary power to stay proceedings in its own court. See Landis v. North American Co., 299 U.S. 248, 254 (1936). Accordingly, the court "may, with propriety, find it is efficient for its own docket and the fairest course for the parties to enter a stay of an action before it, pending resolution of independent proceedings which bear upon the case." Leyva v. Certified Grocers of Cal. Ltd., 593 F.2d 857, 863 (9th Cir. 1979). “[T]he same court that imposes a stay of litigation has the inherent power and discretion to lift the stay.” Canady v. Erbe Elektromedizin GmbH, 271 F. Supp. 2d 64, 74 (D.D.C. 2002).

III. DISCUSSION

Plaintiffs contend that the stay should be lifted because the Court can resolve their request for an injunction on grounds independent of the issues pending before the Supreme Court in ILC II and the Ninth Circuit in CAHF and DSN. Mot. at 3–7.

CV-90 (06/04)

CIVIL MINUTES - GENERAL

Page 3 of 5

Case 2:10-cv-04182-CAS -MAN Document 54 Filed 08/29/11 Page 4 of 5 Page ID #:814
UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA

Case No. Title

CIVIL MINUTES - GENERAL

CV 10-04182 CAS (MANx)

Date August 29, 2011

SIERRA MEDICAL SERVICES ALLIANCE; ET AL v. DAVID MAXWELL-JOLLY; ET AL.

First, plaintiffs maintain that regardless of the Supreme Court’s decision in ILC II, the rate freeze is invalid because none of the claims in the plaintiffs’ proposed first amended complaint is based on defendants’ violation of the Supremacy Clause or the private enforcement of 42 U.S.C. section 1396(a)(30)(A). Id. at 5. Plaintiffs contend that because the grounds for relief in the proposed first amended complaint are distinct from those in ILC II, the basis for maintaining the stay no longer exists. Id.

Next, plaintiffs contend that the resolution of CAHF and DSN, the cases pending before the Ninth Circuit, will not impact the claims in plaintiffs’ proposed first amended complaint, and consequently cannot provide the basis for maintaining the stay. Id. at 7. Plaintiffs assert CAHF only loosely implicates 42 U.S.C. § 1983, arguing that the § 1983 issue in CAHF is limited to whether Medicaid providers may bring a claim under § 1983 to enjoin enforcement of changes to Medi-Cal reimbursement rates prior to federal approval of a State Plan Amendment. Id. at 6. With respect to DSN, plaintiffs argue that the issue to be determined by the Ninth Circuit is whether the relevant California law is preempted by federal law by virtue of the Supremacy Clause. Id. at 5. Plaintiffs assert that because plaintiff’s proposed first amended complaint does not contain any claim based upon preemption, the resolution of DSN is immaterial. Id.

Defendants argue that the claims in plaintiffs’ proposed first amended complaint do not raise distinct issues from those to be determined in ILC II, CAHF and DSN. Opp’n at 3. Specifically, defendants contend that the issue at the heart of these cases, as well as the plaintiffs’ proposed first amended complaint, is the extent to which providers have a private right of action under the Supremacy Clause, 42 U.S.C. § 1983, or some other vehicle to challenge the California’s compliance with provisions of the Medicaid Act or the State Plan Amendment. Id. Accordingly, defendants argue that the Supreme Court’s resolution of ILC II and the Ninth Circuit’s resolution of CAHF and DSN will directly impact this case. Id.

Defendants also assert that sound reasons of judicial economy, conservation of public and private resources, the interests of justice, and the public interest justify continuing the stay pending a ruling in the cases before the Supreme Court and the Ninth Circuit. Id. at 5. Defendants explain that were the Court to lift the stay, defendants would file a motion to dismiss based on the ultimate legal issues to be determined in the Supreme Court and Ninth Circuit. Id.

CV-90 (06/04)

CIVIL MINUTES - GENERAL

Page 4 of 5

Case 2:10-cv-04182-CAS -MAN Document 54 Filed 08/29/11 Page 5 of 5 Page ID #:815
UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA

Case No. Title

CIVIL MINUTES - GENERAL

CV 10-04182 CAS (MANx)

Date August 29, 2011

SIERRA MEDICAL SERVICES ALLIANCE; ET AL v. DAVID MAXWELL-JOLLY; ET AL.

The Court has considered the issues presented by the cases to be decided by the Supreme Court and the Ninth Circuit, and believes that these cases present issues that will ultimately impact the outcome of the present matter.3 Moreover, in light of the fact that oral argument in ILC II is set in the Supreme Court for October 3, 2011 and oral argument in CAHF and DSN is set in the Ninth Circuit for October 11, 2011, the prejudice, if any, caused by maintaining the stay in place until the resolution of those cases will be minimal.

IV. CONCLUSION

In accordance with the foregoing, the Court hereby DENIES plaintiffs’ motion to lift the stay and place the case on the Court’s active list. The parties shall continue to file quarterly status reports detailing the status of the case until the action has been reactivated on this Court’s active caseload or a stipulation for dismissal is filed.

IT IS SO ORDERED.

Initials of Preparer

00 RS

: 00

3 At oral argument, counsel for plaintiffs argued that plaintiffs’ proposed first

amended complaint does not concern the private enforcement of 42 U.S.C. section

1396(a)(30)(A). After reviewing plaintiffs’ proposed first amended complaint, the Court

finds that however the complaint is styled, the issues tend to overlap with those of ILC II,

CAHF, and DSN. Accordingly, the Court finds it prudent to maintain the stay pending

the resolution of those cases.

CV-90 (06/04)

CIVIL MINUTES - GENERAL

Page 5 of 5

 
 Case 2:10-cv-04182-CAS-MAN CDOoNcFuOmRMeEnDt 6C7OPYFiled 09/20/12 Page 1 of 35 Page ID #:924

1 Andrew H. Selesnick (SBN 160516) aselesnick(ci)mrllp. com
2 Kevin R. Warren (SBN 242238) kwarren(ii)mrllp.:. com
3 MICHEt:MAN & ROBNSON LLP 15760Ventura Blvd., 5th Floor
4 Encino, California 91436 Teleph<?ne: (818) 783-5530
5 Facs1mlle: (818) 783-5507

Cf\utOI\NI~ ct.NiRIIL 0\SiR\CI Or Dt?\lij__
B~

6 Attorneys for :Plaintiffs

7

8

THE UNITED STATES DISTRICT COURT FOR THE

9

CENTRAL DISTRICT OF CALIFORNIA

10

. 11 SIERRA MEDICAL SERVICES

Case No. CV 10-04182 CAS

ALLIANCE, CARE FLIGHT, RIGGS

(MANx)

12 AMBULANCE SERVICE INC.,

SCHAEFER AMBULANCE.SERVICE,

13 INC., AMERICAN AMBULANCE OF

FIRST AMENDED COMPLAINT

VISALIA, DESERT AMBULANCE

14 SERVICE, SAN LUIS AMBULANCE

SERVICE, INC., FIRST RESPONDER

15 EMERGENCY MEDICAL SERVICES-

c!

SACRAMENTO, INC., FIRST 1

16 RESPONDER EMERGENCY MEDICAL

SERVICES, INC., IMPERIAL

17 AMBULANCE SERVICES, INC., EXETER

DISTRICT AMBULANCE, SIERRA

18 LIFESTAR, INC., d.b.a, LIFESTAR

AMBULANCE, DEL NORTE

19 AMBULANCE, INC., PINER'S

20 trJriSF:tf>~~lf Wix~Mf1H~~~

SERVICE, PROGRESSIVE AMBULANCE,

21 INC., d.b.a., LIBERTY AMBULANCE,

HALL AMBULANCE SERVICE, INC.,

22 CITY AMBULANCE OF EUREKA, INC.,

PATTERSON DISTRICT AMBULANCE,

23 K.W.P.H. ENTERPIRSES, d.b.a.,

AMERICAN AMBULANCE

24 COMMUNITY AMBULANCE SERVICES,

INC., SIERRA AMBULANCE SERVICE,

25 INC., CARE AMBULANCE SERVICE,

INC,, DELANO AMBULANCE SERVICE,

26 INC., KERN EMERGENCY MEDICAL

TRANSPORTATION CORPORATIO~

27 d.b.a;, KERN AMBULANCE, MANTEcA

DISTRICT VOLUNTEER AMBULANCE

28 SERVICE, dba MANTECA DISTRICT

1

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 2 of 35 Page ID #:925

13

14

JURISDICTION

15

1. This action involves federal questions arising under the laws and

16 Constitution of the United States, including, but not limited to Article I, Sections 8

17 and 10 of the United States Constitution, 42 U.S.C. § 1983 and the Fifth and

18 Fourteenth Amendments to the United States Constitution. This Court has subject

19 matter jurisdiction over this action pursuant to 28 U.S.C. §§ 1331, 1343, 2201 and

20 2202.

21

2. Venue is proper in the Central District because a substantial part of the

22 events or omissions giving rise to the claim occurred in this District. In addition, all

23 Defendants reside in this State and Defendants have agreed that an action against them

24 may be commenced in any city in which the Attorney General of the state has an

25 office. The Attorney General has an office in this District.

26

27 28

2

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 3 of 35 Page ID #:926

1

INTRODUCTION

2

3. Plaintiffs provide medical transportation services to over 21 million

3 Californians in 31 of the State's 58 counties. Certain Plaintiffs also provide medical

4 transportation services outside California. Collectively, Plaintiffs safeguard the lives

5 of more than half of California's population by standing ready to assist these 20

6 million Californians in emergency situations seven days a week, 24 hours a day.

7 Plaintiffs also provide non-emergency ambulance services to those Californians who

8 have special needs and who do not have a reliable source of transportation to obtain

9 essential medical treatment. Plaintiffs provide over 100,000 medical transports of 10 Defendants' Medi-Cal clients each year. Defendants pay approximately 20% of

11 Plaintiffs' actual cost of each of these transports, which is on average, $775.00.

12 Consequently, Defendants force Plaintiffs to subsidize Medi-Cal with over $60

13 million of their private funds and physical property each year.

14

4. Because California law requires that medical transportation services to

15 Medi-Cal clients be reimbursed "at the lesser of usual charges or the limits specified 16 in the California Code ofRegulations," and because Section 51527 of the Code of

17 Regulations was promulgated by Defendants in violation of Plaintiffs' Constitutional

18 rights, Plaintiffs seek prospective relief in the form of a permanent injunction

19 prohibiting Defendants from reimbursing Plaintiffs less than their "usual charges" for

20 the services they provide to Defendants' Medi-Cal clients.

21

22

PARTIES

23

5. Plaintiff Sierra Medical Services Alliance ("SEMSA") is a 501c(3) non-

24 profit organization. SEMSA is the exclusive provider of ambulance services for

25 emergency (911) and non-emergency calls in Lassen County, California. SEMSA's

26 franchise provider agreement was awarded through a competitive bid process in 2005

27 and its contract is effective through 2015, plus any additional earned extensions.

28 SEMSA's service rates are set and regulated by the County of Lassen.

3

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 4 of 35 Page ID #:927

1

6. Plaintiff Care Flight is a division of Regional Emergency Medical

2 Services Authority, a 501 c(3) non-profit organization affiliated with SEMSA. Care

3 Flight provides emergency medical helicopter s~rvices in northern California and

4 northern Nevada. Care Flight operates through provider agreements with regional

5 emergency medical services agencies, including Sierra Sacramento Valley EMSA.

6

7. PlaintiffRiggs Ambulance Service, Inc., is the exclusive provider.of

7 ambulance services for emergency (911) and non-emergency calls in Merced County.

8 Riggs Ambulance Service's franchise provider agreement was awarded through a

9 competitive bid process in 2003 and its contract is effective through 2012. Riggs

10 Ambulance Service rates are set and regulated through the County of Merced.

11

8. Plaintiff Schaefer Ambulance Service Inc. serves six of the most

12 populous counties in southern California including Los Angeles, Orange, San Diego,

13 San Bernardino, Riverside, and Imperial. Schaefer Ambulance has emergency (911)

14 contracts in Los Angeles and Imperial Counties. Schaefer provides a significant

15 amount of non-emergency medical transportation in Orange, San Diego, San

16 Bernardino and Riverside counties. Schaefer is engaged in a number of pilot

17 programs including critical care programs in Los Angeles County and neonatal infant

18 transportation programs in Los Angeles, Riverside, and San Bernardino counties.

19 Schaefer serves approximately 15 million people living in approximately 13,600

20 square miles of service area.

21

9. Plaintiff C.H.L. EMS, Incorporated, dba AmericanAmbulance of

22 Visalia, provides emergency (911) and non~emergency medical transportation services

23 in a shared exclusive operating area. C.H.L. operates pursuant to an agreement with

24. the County of Tulare that runs from March 1, 2009 to June 30, 2014.

25

10. Plaintiff Desert Ambulance Service, Inc., is designated as an exclusive

26 provider of emergency (911) and non-emergency medical transportation services

27 pursuant to an agreement with San Bernardino County. Desert Ambulance's service

28

4

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 5 of 35 Page ID #:928

1 area is designated as an exclusive non-competitive area pursuant to Health and Safety

2 Code section 1797.224.

3

11. ·Plaintiff San Luis Ambulance Service, Inc., is the exclusive provider of

4 ambulance services for emergency (911) and non-emergency calls in three of the four

5 designated ambulance zones in San Luis Obispo County pursuant to a franchise

6 provider agreement that is effective into 20 13.

7

12. Plaintiff First Responder Emergency Medical Services-Sacramento, Inc.

8 is a non-exclusive provider of ambulance services for emergency and non-emergency

9 calls within the Sacramento, Placer andYolo Counties.

I

10

13. Plaintiff First Responder Emergency Medical Services, Inc. operates as

11 an exclusive provider of emergency (911) and non-emergency ambulance services in

12 Butte County. Responder's service area is designated as an exclusive non-competitive

13 area pursuant to Health and Safety Code section 1797.224.

14

14. Plaintiff Imperial Ambulance, Inc. provides emergency (911) and non-

15 emergency ambulance services in Tulare County pursuant to a contract with Tulare

16 County that is effective through June 30, 2014. Within Tulare County, Imperial

17 Ambulance, Inc. responds primarily inthe City ofPorterville and the City of Lindsay.

18 When called upon, Imperial provides service to all other city and rural areas within

19 Tulare County.

20

15. Plaintiff Exeter District Ambulance operates as an exclusive provider of

21 emergency (911) and non-emergency ambulance services in the north eastern region

22 ofTulare County.

23

16. Plaintiff Sierra LifeStar, Inc., d.b.a. Lifestar Ambulance, operates as an

24 exclusive provider of emergency (911) and non-emergency ambulance services in

25 Tulare County.

26

17. Plaintiff Del Norte Ambulance, Inc. operates as an exclusive provider of

27 emergency (911) and non-emergency ambulance services in Del Norte County.

28

5

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 6 of 35 Page ID #:929

1

18. PlaintiffNapa Ambulance Service, Inc., dba.Piner's Ambulance, operates

2 as an exclusive provider of emergency (911) and non-emergency ambulance services

3 in Tulare County. Napa's exclusive provider agreement was awarded through a

4 competitive bid process in 2001 and it is effective through 2011.

5

19. Plaintiff American Legion Post 108 Ambulance Service ("ALA") is a

6 SOle (19) non-profit corporation. ALA is the exclusive provider of ambulance

7 services for emergency (911) and non-emergency calls in Amador County pursuant to

8 · a franchise provider agreement that is effective through 2013. ALA has been the sole

9 ambulance provider in Amador County since 1929. ALA is also the exclusive

10 provider of ambulance services for emergency (911) and non-emergency calls in

11 Calaveras County pursuant to a franchise provider agreement that is effective through

12 2014.

l3

20. Plaintiff Progressive Ambulance, Inc, dba Liberty Ambulance, is the

14 exclusive provider for emergency (911) and non-emergency ambulance services in

15 Kern County's Operational Area #7. Liberty's franchise provider agreement was

16 awarded pursuant to Health and Safety Code section 1797.224 and is effective until

17 2019.

18

21. Plaintiff Hall Ambulance Service, Inc. is the exclusive provider for

19 emergency (911) and non-emergency ambulance services in Kern County Ambulance

20 Service Operational Areas 2, 4, 5, 8, 9 and 11. Operating Area(s) 2,4,5,8 & 9 were

21 awarded pursuant to Health and Safety Code section 1797.224. Operational Area 11

22 was awarded to Hall in 1994 through a competitive bid process.

23

22. Plaintiff City Ambulance of Eureka, Inc provides emergency (911) and

24 non-emergency ambulances in the County of Humboldt.

25

23. Plaintiff Patterson District Ambulance is the exclusive provider of

26 ambulance services for emergency (911) and non-emergency calls within Zone #5 of

27 Stanislaus County. The Patterson District Ambulance franchise provider agreement

28 was established in 1992 by the County pursuant to California Health and Safety Code

6

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 7 of 35 Page ID #:930

1 1797.224 and remains in effect. A performance contract, required with the County, is

2 effective through 2012.

3

24. PlaintiffK.W.P.H. Enterprises, d.b.a. American Ambulance, is the

4 exclusive provider of ambulance services for emergency (911) and non-emergency

5 calls in the Fresno County Exclusive Operating Area and the County of Kings. The

6 provider agreements for these service areas were awarded through competitive bid

7 processes.

8

25. Plaintiff Community Ambulance Services, Inc. dba CARE Ambulance is

9 the exclusive provider of ambulance services for emergency (911) and non-emergency

10 calls in Kern County Operating Area #6. CARE's franchise provider agreement was

11 awarded pursuant to Health and Safety Code section 1797.224.

12

26. Plaintiff Sierra Ambulance Service, Inc., is a 501 c(3) non-profit

13 organization. Sierra Ambulance is the exclusive provider of ambulance services for

14 emergency (911)' and non-emergency calls in eastern Madera County. Sierra has been

15 the exclusive 911 ambulance provider in eastern Madera County since 1965. It

16 operates under a California Health and Safety Code 1797.224 exclusive agreement

17 with the Central California EMS Agency.

18

27. Plaintiff Care Ambulance Service, Inc. is the exclusive 911 Emergency

19 Ambulance provider for the Orange County, California cities of Anaheim, Buena

20 Park, Costa Mesa, Cypress, Fountain Valley, Fullerton, Garden Grove, La Palma, Los

21 Alamitos, Seal Beach, and Stanton, as well as Exclusive Operating Area number six

22 (6) in Los Angeles County, California, which is comprised of the cities of Artesia,

23 Bell, Bell Gardens, Bellflower, Cerritos, Commerce, Cudahy, Hawaiian Gardens, La

24 Mirada, Lakewood, Huntington Park, Maywood, Montebello, Norwalk, Paramount,

25 Pico Rivera, Santa Fe Springs, Signal Hill, Whittier, and the unincorporated areas of

26 Florence-Graham and East Los Angeles. All franchise agreements were awarded

27 thorough a competitive bid process.

28

7

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 8 of 35 Page ID #:931

1

28. Plaintiff Delano Ambulance Service, Inc. is the exclusive provider of

2 ambulance services for all emergency (911) and non-emergency calls in Kern County

3 for the Exclusive Operating Area #3. Delano has an ongoing franchise agreement

4 with the County of Kern.

5

29. Plaintiff Kern Emergency .Medical Transportation Corporation, dba Kern

6 Ambulance, is the exclusive provider for emergency (911) and non-emergency

7 ambulance services in Kern County's Operational Area #1. Kern Ambulance's

8 provider agreement was awarded pursuant to California Health and Safety Code

9 1797.224 and the contract is effective until2019.

10

30. Plaintiff Manteca District Volunteer Ambulance Service, dba Manteca

11 District Ambulance Service, is a 501c(3) non-profit corporation and is the exclusive

12 provider for emergency (911) and non-emergency ambulance services in the City of

13 Manteca and surrounding areas including parts of Tuolumne County.

14

31. Plaintiff California Ambulance Association is a trade association that

15 represents the interests of emergency ambulance service providers who serve the

16 residents of nearly every county in California. Each ofthe CAA's members would

17 otherwise have standing to sue in their own right and the interests it seeks to protect

18 are germane to the organization's purpose. Moreover, neither the claims asserted nor

19 the relief requested herein requires the participation of the individual members in the

20 lawsuit.

21

32. PlaintiffRegional Emergency Medical Services Authority is a 501c(3)

22 non-profit organization in the state of Nevada. REMSA holds an exclusive franchise

23 to provide all ground ambulance services for the geographic area of Washoe County,

24 including the cities of Reno and Sparks. The total population covered by REMSA is

25 approximately 350,000, and REMSA responds to approximately 60,000 calls per year.

26 REMSA's performance-based franchise is governed by an appointed Board of

27 Directors and contractually reports to the Washoe County District Board of Health.

28 The franchise agreement requires REMSA to respond to, and to render aid to, all

8

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 9 of 35 Page ID #:932

1 individuals who require emergency or non-emergency ambulance services who

2 request assistance anywhere iri the contract area.

3

33. Plaintiff Metro West Ambulance Service, Inc. is the exclusive provider of

4 ambulance services for all emergency and non-emergency calls in Washington

5 County, Oregon. Metro West has had an exclusive franchise agreement with the

6 County of Washington since 1997 and has provided the majority ofthe County's

7 emergency transportation services for the past 57 years.

8

34. Plaintiff Westmed Ambulance, Inc., d.b. a., McCormick Ambulance is a

9 provider of emergency (911) and non-emergency services in portions of Los Angeles

10 County. On March 14, 2006, the Los Angeles County Board of Supervisors

11 unanimously selected McCormick Ambulance to be one of four ambulance companies

12 to provide emergency 911 services throughout the county. McCormick serves

13 approximately 1.5 million people located in zones 4 and 7 in Los Angeles County and

14 responds to approximately 80,000 emergency calls each year.

15

35. Defendant David Maxwell-Jolly is the former Director of the Department

16. of Health Care Services of the State of California. Maxwell-Jolly acted under color of

17 state authority at all times mentioned herein. Because Maxwell-Jolly acted willfully,

18 maliciously and with reckless indifference to and in disregard of Plaintiffs' rights, in

19 excess of the authority granted to him by law, he is sued in his individual capacity.

20

36. Defendant Toby Douglas is the current Director of the Department of

21 Health Care Services of the State of California. Douglas has acted under color of state

22 authority at all times mentioned herein. Douglas is sued in his official capacity. In

23 addition, because Douglas acted willfully, maliciously and with reckless indifference

24 to and in disregard of Plaintiffs' rights, in excess of the authority granted to him by

25 law, he is sued in his individual capacity.

26

27

28

9

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 10 of 35 Page ID #:933

1

MEDICAID AND STATE COUNTERPARTS

2

37. Medicaid is a federal program that provides medical care to needy

3 individuals by giving states funds to use to administer medical assistance programs.

4 (42 U.S.C. 1396, et seq.)

5

38. Participation in the Medicaid program is voluntary. To participate, a

6 state must submit, and have approved, a state plan for Medicaid assistance that

7 complies with the federal Medicaid statutes and the regulations adopted by the

8 Secretary of the United States Department of Health and Human Services. One of the

9 Department's divisions, The Centers for Medicare and Medicaid Services, is

10 responsible for approving or rejecting a state's plan.

11

39. A state plan specifies how a state will operate its medical assistance

12 program in compliance with federal law and provides assurances that the state will

13 administer its program "in conformity with the specific requirements of title XIX, the

14 regulations in this Chapter IV, and other applicable official issuances of the

15 Department [ofHealth and Human Services]." (42 C.P.R. 430.10.) To be approved,

16 it must specify which groups of people are eligible, the types and ranges of services to

17 be provided, the policy and methods to be used to establish payment rates for medical 18 service providers such as Plaintiffs, 1 and other components of the state's proposed

19 program that are required by federal law.

20

40. Once a state's plan is approved, The Centers for Medicare and Medicaid

21 Services provide federal funds to the state for the operation of its program as

22 described in its state plan.

23

41. California has chosen to participate in the Medicaid program. Medi-Cal

24 is the State's Medicaid program that provides benefits to poor individuals who satisfy

25 certain eligibility requirements. (California Welfare and Institutions Code, Section

26 14000, et seq.; California Code of Regulations, Title 22, Section 50000, et seq.)

27

28 1 42 C.P.R. 447.201
10

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 11 of 35 Page ID #:934

1

42. California's State Plan states that, "[a]s a condition for receipt of Federal

2 funds under title XIX of the Social Security Act, the Department of Health Services

3 (Single State Agency) submits the following State plan for the medical assistance

4 program, and hereby agrees to administer the program in accordance with the

5 provisions of this State plan, the requirements of titles XI and XIX of the Act, and all
~
6 applicable Federal regulations and other official issuances of the Department."

7 (California State Plan, Plan Submittal Statement, page 1.) California's State Plan was

8 approved by The Centers for Medicare and Medicaid Services and California receives 9 federal funds for its operation.

10

11

CALIFORNIA'S GUARANTEE

12

OF MEDICAL TRANSPORTATION SERVICES

13

43. 42 U.S.C., Section 1396a, et seq., and 42 C.P.R., Part 430 et seq., set

14 forth the requirements a State Plan must satisfy in order to qualify for approval.

15 Defendants certified that, "[t]he plan is in operation on a Statewide basis in

16 accordance with all requirements of 42 CFR 431.50." (California State Plan, Section 17 1.3, page 8.)

18

44. Pursuant to federal requirements, a state plan must "[s]pecify that the

19 Medicaid agency will ensure necessary transportation for recipients to and from 20 providers" and "[d]escribe the methods that the agency will use to meet this 21 requirement." (42 C.P.R. 431.53.)

22

45. California certified to the federal government that, "[u]nder California's

23 Title XIX State Plan, transportation of eligible recipients to and from health care

24 services is assured through a variety of methods ... [including] the provision of

25 medical transportation as a direct benefit of the Title XIX program ... [consisting of]

26 both emergency and nonemergency medical transportation." (California State Plan 27 Under Title XIX, 3.1(c)(l) and Attachment 3.1-D.)

28

11

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 12 of 35 Page ID #:935

1

SETTING MEDI-CAL REIMBURSEMENT RATES FOR

2

MEDICAL TRANSPORTATION SERVICES

3

46. A state plan must "describe the policy and the methods to be used in

4 setting payment rates for each type of service included in the State's Medicaid

5 program." (42 C.P.R. 447.201.) Medical transportation services are covered in

6 Attachment 4.19-B, page 1, of the State Plan:

7

[t]he policy of the State Agency is that reimbursement

8

for each of the other types of care or service listed in

9

Section 1905(a/ of the Act that are includ~d in the

10

program under the plan will be at the lesser of usual

11

charges or the limits specified in the California code

12

of Regulations ... [t]he methodology utilized by the

13

State Agency in establishing payment rates will be as

14

follows:

15

(a) The development of an evidentiary base or rate

16

study resulting in the determination of a

17

proposed rate.

18

(b) To the extent required by State or Federal law

19

or regulations, the presentation of the proposed

20

rate at public hearing to gather public input to

21

the rate determination process.

22

(c) The determination of a payment rate based on

23

an evidentiary· base, including pertinent input

24

.from the public.

25

(d) The establishment of the payment rate through

26

the State Agency's adoption of regulations

27

specifying such rate in the CCR ...

28
2 Section 1905(a) is the former designation of 42 U.S.C. 1396d
12

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 13 of 35 Page ID #:936

1

47. Accordingly, pursuant to this rule, drafted by Defendants and approved

2 by CMS, medical transportation services must be reimbursed at "the lesser of usual

3 charges," or at a statutory rate that is determined by the methodology described above

4 and that is based upon credible evidence of the actual cost of providing the service or

5 the prevailing rates for the service.

6

7

PUBLIC INPUT AND REGULATION ADOPTION PROCEDURES

8

GUARANTEED BY THE STATE OF CALIFORNIA

9

48. Pursuant to the Administrative Procedure Act, California Government

10 Code, Sections 11346, et seq., the Legislature has established basic minimum

11 procedural requirements for the adoption, amendment or repeal of administrative

12 regulations.

13

49. Pursuant to Government Code, Section 11346.4, there must be a public

14 comment period on all proposed regulations, with advance notice of at least 45 days of

15 the close of that comment period. Section 11346.5 of the Code establishes the

16 requirements for the notice of proposed regulations, which must include, inter alia, a

17 statement of the time, place and nature of proceedings for the adoption, amendment or

18 repeal of the regulation, reference to the authority under which the r~gulation is

19 promulgated, and an informative digest containing a concise and clear summary of

20 existing laws and regulations related directly to the proposed action and the effect of

21 the proposed action.

22

50. Pursuant to Government Code, Section 11349.3, the Office of

23 Administrative Law ("OAL") must review all regulations after they have been

24 subjected by the issuing agency to the notice and comment procedures, and make

25 determinations using the following criteria: Necessity, authority, clarity, consistency,

26 reference and non-duplication. The OAL may disapprove the regulations, in which

27 case it shall return them to the adopting agency with a written statement of

28

13

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 14 of 35 Page ID #:937

1 disapproval. If OAL approves the proposed regulations, then it shall forward them to

2 the Secretary for filing.

3

51. California law requires that, "[i]n order to increase public participation

4 and improve the quality of regulations, state agencies proposing to adopt regulations

5 shall, prior to publication of the notice required by Section 11346.5, involve parties

6 who would be subject to the proposed regulations in public discussions regarding

7 those proposed regulations, when the proposed regulations involve complex proposals

8 or a large number of proposals th-at cannot easily be reviewed during the comment

9 period" (California Government Code, Section 279.)

10

11

DEFENDANTS REFUSE TO REIMBURSE PLAINTIFFS FOR THE

12

SERVICES THEY ARE REQUIRED BYLAW TO PROVIDE TO

13

DEFENDANTS' MEDI-CAL CLIENTS

14

52. To ensure an efficient and fully responsive emergency transportation

15 system for all Californians, local emergency medical services jurisdictions "shallplan,

16 implement, and evaluate an emergency medical services system ... consisting of an

17 organized pattern of.readiness and response services based on public and private

18 agreements and operational procedures." (California Health and Safety Code, Section

19 1797.204.) Where local governments cannot provide emergency services, they must

20 allocate market rights to specific ambulance companies via competitive process or 21 assigned contract.3 (California Health and Safety Code, Section 1797.224.) California

22 law mandates that emergency medical transportation services are only provided

23 through this system and that no emergency services provider may operate without

24 government approval and an assignment of market rights. Emergency transportation

25 services providers are under an absolute legal duty to provide service on demand to all

26 requestors without discrimination. Moreover, they may not discontinue unprofitable

27

28 3 Assignment is limited to statutorily proscribed circumstances when a provider has been providing uninterrupted service since at least January 1, 1981.
14

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 15 of 35 Page ID #:938

1 services or redirect their efforts from unprofitable services to those that are profitable

2 or simply cover their costs, and they must expand their facilities and services to meet

3 demand even where rates do not fully compensate them for the cost of providing the 4 serv1ce.

5

53. Emergency transportation services providers must, and do, dedicate their

6 property to public service. They exist solely and exclusively to provide an essential

7 public service where local governments cannot. Every local jurisdiction in California

8 requires that designated service providers respond to every emergency call that is

9 received. Consequently, Plaintiffs cannot choose to decline to provide service to

10 Defendants' Medi-Cal clients. In fact, Plaintiffs cannot even identify Defendants'

11 Medi-Cal clients as such prior to or during their provision of service to them.

12

54. Nor can Plaintiffs withdraw from the provision of emergency

13 transportation services without government approval. To do so would place those

14 experiencing life-threatening emergencies in Plaintiffs' service areas at risk of death.

15 So important is continuity of emergency transportation services that Plaintiffs are

16 subject to strict government rules and regulations and non-cancellable contractual

17 provisions that allow supervising government entities to appropriate all of Plaintiffs'

18 equipment and facilities if Plaintiffs do not respond to every emergency call for

19 service in their assigned geographic areas.

20

55. In addition, every county in the state is required to follow California

21 Emergency Medical Services Authority ("EMSA") guidelines in designating the

22 required service levels for emergency medical transportation services. Local

23 Emergency Medical Services Agencies (LEMSAs) submit plans evidencing their

24 compliance with state EMSA guidelines to the State of California, which must 25 approve the plans.

26

56. Each jurisdiction mandates specific service level requirements. These

27 mandates include the requirement that the jurisdiction's service provider maintain an

28 "advanced life support" state of readiness and level of care for all emergency

15

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 16 of 35 Page ID #:939

1 transports. Consequently, every ambulance must be staffed with at least one

2 paramedic, one emergency medical technician and must carry equipment designed to

3 provide advanced life support to a patient.

4

57. Advanced life support is defined by California law as,"... special

5 services designed to provide definitive prehospital emergency medical care, including,

6 but not limited to, cardiopulmonary resuscitation, cardiac monitoring, cardiac

7 defibrillation, advanced airway management, intravenous therapy, administration of

8 specified drugs and other medicinal preparations, and other specified techniques and

9 procedures administered by authorized personnel under the direct supervision of a

10 base hospital as part of a local EMS system at the scene of an emergency, during

11 transport to an acute care hospital, during interfacility transfer, and while in the

12 emergency department of an acute care hospital until responsibility is assumed by the.

13 emergency or other medical staff of that hospital." (California Health and Safety

14 Code, Section 1797.52.)

15

58. Advanced life support services are significantly more expensive to

16 provide than basic life support services because they require more highly trained and

17 certified personnel, a larger quantity of, and more sophisticated equipment, and a

18 significantly higher level of supervision than basic life support service.

19

59. California Code ofRegulations, Section 51527, which sets the Medi-Cal

20 reimbursement rates for medical transportation services, provides payment for "BLS"

21 or basic life support transports. Section 51527 does not allow reimbursement for

22 advanced life support service, the result of which is an unfunded mandate by the

23 Defendants that Plaintiffs provide advanced life support services at no cost to

24 Defendants.

25

60. Defendants have never developed an evidentiary base or rate study

26 concerning medical transportation services costs that resulted in the determination of a

27 proposed rate.

28

16

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 17 of 35 Page ID #:940

1

61. Defendants have never presented proposed rates regarding medical

2 transportation services at a public hearing to gather public input about rate

3 determination despite the complexity of the medical transportation services industry

4 and the costs associated with operating such services in a wide range of geographic

5 locations and under a wide range of conditions.

6

62. Defendants have never made a determination of payment rates for

7 medical transportation services based on an evidentiary base which included pertinent

8 input from the public. Instead, Defendants unilaterally set payment rates for medical

9 transportation services and codified those rates at Section 51527 ofthe California

10 Code ofRegulations.

11

63. On multiple occasions, Plaintiffs requested, in person and in writing, that

12 Plaintiffs Maxwell-Jolly and Douglas comply with Attachment 4.19-B to the State

13 Plan. As directors of the Department of Health Care Services, each of them had a

14 legal obligation to follow the policies and procedures of the Department. Both

15 Maxwell-Jolly and Douglas refused to follow the policy and procedure set out by the

16 Department itself in Attachment 4.19-B, acts that exceeded their authority as Directors

17 ofthe Department. Because the requirements of Attachment 4.19-B are clear and

18 unambiguous, Maxwell-Jolly's and Douglas' duties were clear and direct. Neither

19 Maxwell-Jolly nor Douglas reasonably relied on existing law in their refusals to

20 follow the legal requirements of Attachment 4.19-B. Maxwell-Jolly's and Douglas'

21 refusals to comply with Attachment 4.19-B are serious misuses and abuses of their

22 authority as directors of the Department. Maxwell-Jolly and Douglas each ignored

23 their legal duties to obtain personal benefits, including, but not limited to, garnering

24 favor with their supervisors to obtain promotions within the state's government

25 bureaucracy and obtaining personal financial benefits. Because Maxwell-Jolly and

26 Douglas, in intentionally and willfully doing the acts described herein, far exceeded

27 the authority granted to them by California law, they have subjected themselves to

28 liability in their individual capacities for Plaintiffs' economic damages.

' 17

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 18 of 35 Page ID #:941

1

64. Defendants' actions violate Plaintiffs' Fifth and Fourteenth Amendment

2 rights guaranteed by United States Constitution as well as Article I, Section 10, Clause

3 1 and Article I, Section 8, Clause 3 of the United States Constitution. Plaintiffs do not

4 have an adequate legal remedy to redress their prospective Constitutional injuries,

5 therefore, an injunction is necessary. Plaintiffs are currently suffering irreparable

6 injury because they must, pursuant to California law, use their private funds and their

7 private property to treat and transport Defendants' Medi-Cal clients without

8 reimbursement of the funds or replacement of the property. Plaintiffs are required to ·

9 accept payment rates illegally established by Defendants and cannot seek additional

10 payments from Defendants' clients. On balance, the harm suffered by Plaintiffs

11 substantially outweighs any harm that could befall Defendants by issuing the

12 injunction Plaintiffs are seeking. Plaintiffs request only that Defendants be required to 13 follow the law, which was enacted for the greater benefit of all Californians.

14

15

FIRST CLAIM FOR RELIEF

16

17

TAKING PRIVATE PROPERTY FOR PUBLIC USE

WITHOUT JUST COMPENSATION

18

FIFTH AMENDMENT TO THE UNITED STATES CONSTITUTION,

19

42 u.s.c. § 1983

20

65. Paragraphs 1 through 64 are incorporated by reference as if fully set forth

21 herein.

22

66. The Fifth Amendment to the United States Constitution prohibits the

23 government from taking private property for public use without just compensation.

24

67. "Every person who, under color [of law] ... subjects, or causes to be

25 subjected, any citizen of the United States ... to the deprivation of any rights,

26 privileges, or immunities secured by the Constitution and laws, shall be liable to the

27 party injured in an action at law, suit in equity, or other proper proceeding for

28

18

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 19 of 35 Page ID #:942

1 redress." 42 U.S.C. 1983. This statute furnishes a cause of action for the violation of

2 federal rights created by the United States Constitution.

3

68. Medi-Cal is a purely public social welfare program. Defendants,

4 directors of the California Department of Health Care Services are state actors who

5 have administered, or do administer, the Medi-Cal program. The director makes all

6 decisions regarding the establishment of reimbursement policies and regulations, and

7 is responsible for gathering and analyzing the information and data that is necessary to

8 establish fair and equitable reimbursement rates for all providers, including providers

9 of emergency transportation services. Moreover, the director makes all decisions

10 regarding if, when and how the Department will follow its own regulations, California

11 law and federal law regarding the provision of services to its Medi-Cal clients and the

12 setting of provider reimbursement rates. Defendants are duly authorized by law to

13 administer the Medi-Cal program.

14

69. Plaintiffs are required by law to respond to all emergency calls and

15 provide emergency treatment and transportation to every Medi-Cal client that requests

16 emergency assistance, a fact known by Maxwell-Jolly and Douglas. Plaintiffs cannot

17 choose to decline to treat or transport Defendants' Medi-Cal clients or even. identify

18 them prior to treatment or transport to have the option of declining to treat or transport

19 them. Plaintiffs have dedicated their property to public service and they may not

20 withdraw from providing emergency transportation services to the general public or to

21 Defendants' Medi-Cal clients without government approval.

22

70. Defendants effect a taking of Plaintiffs' private property: "As a direct

23 benefit, California provides both emergency and nonemergency medical

24 transportation." (Attachment 3.1-D.) Defendants do not possess, contract for or

25 otherwise provide emergency transportation services in the geographic areas served by

26 Plaintiffs.

27

71. Plaintiffs have not voluntarily elected to participate in Defendants' Medi-

28 Cal program. Plaintiffs are compelled to use their private funds and private property,

' 19

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 20 of 35 Page ID #:943

1 which are protectable property interests, for a purely public purpose: To treat and

2 transport Defendants' Medi-Cal clients. Defendants reimburse Plaintiffs, on average; 3 20% of the value of the funds and property Plaintiffs must use to serve Medi-Cal 4 clients.

5

72. Defendants' refusal to reimburse Plaintiffs at a level that, at a minimum,

6 covers their cost to provide the service is a taking of Plaintiffs' private property for

7 public use. Defendants' actions do not advance any state interest as the actions are, on

8 their face, contrary to the stated state interests regarding emergency transportation

9 services providers set forth by Defendants in their policies, procedures and

10 regulations, and by the by the State of California and the federal government in their

11 laws and regulations.

12

73. In addition, Defendants"limit Plaintiffs' payment for the treatment and

13 transportation of Medi-Cal clients to the amount that Defendants set. Plaintiffs may

14 not bill Defendants' clients for the difference between Defendants' rates and the actual

15 cost of providing the service. Defendants' payment is the maximum amount Plaintiffs

16 can recover for their services.

17

74. Because Defendants refuse to reimburse Plaintiffs for, at a minimum, the

18 amount of money and property Plaintiffs are compelled to use to treat and transport

19 clients of the purely public Medi-Cal program, knowing that Plaintiffs must use their

20 private funds and property, Defendants are taking Plaintiffs' private property for

21 public use without providing just compensation. Defendants have exceeded their legal

22 authority and have violated Plaintiffs' civil rights.

23

24

25

26

27

28 ///

20

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 21 of 35 Page ID #:944

1

SECOND CLAIM FOR RELIEF

2

3

VIOLATION OF PROCEDURAL DUE PROCESS

FIFTH AND FOURTEENTH AMENDMENTS TO THE UNITED STATES

4

CONSTITUTION,

5

42 u.s.c. § 1983

6

75. Paragraphs 1 through 74 are incorporated by reference as if fully set forth

7 herein.

8

76. The Fifth Amendment requires reasonable notice and opportunity to be

9 heard before the government deprives a person of a property interest.

10 -

77. Plaintiffs have a significant and protectable property interest in the

1i private funds they spend and the private property they are compelled to use to

12 transport and treat Medi-Cal clients. Plaintiffs also have a protectable property

13 interest in the contracts they hold with various cities, counties and special districts.

14

78. Defendants reimburse Plaintiffs only a small portion of the cost of

15 providing these services to Medi-Cal Clients and prohibit them from obtaining any

16 additional reimbursement.

17

79. The California Government Code, Section 11346, et seq., requires that

18 Defendants follow certain minimum procedures before enacting regulations such as

19 Section 51527. Defendants have not complied with any procedural requirement of the

20 Code.

21

80. The State Plan sets forth a specific procedure, drafted and implemented

22 by Defendants, that Defendants must follow to set reimbursement rates for Plaintiffs.

23 Specifically, "[t]he methodology utilized by the State Agency in establishing payment

24 rates will be as follows: (a) The development of an evidentiary base or rate study

25 resulting in the determination of a proposed rate; (b) To the extent required by State

26 or Federal law or regulations, the presentation of the proposed rate at public hearing to

27 gather public input to the rate determination process; (c) The determination of a

28 payment rate based on an evidentiary base, including pertinent input from the public."

21

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 22 of 35 Page ID #:945

1 Defendants have not complied with these procedural requirements. Instead,

2 Defendants unilaterally set the rates in Section 51527, without giving notice of a

3 hearing or allowing input from any party that was to be affected by the rates.

4

81. Defendants have never given notice of their proposed rates or allowed

5 . input from Plaintiffs about the rate determination process. Defendants' actions are so

6 arbitrary and unfair as to constitute a violation of Plaintiffs' due process rights.

7 Without being provided notice or a hearing, Plaintiffs have been summarily denied

8 their property interest in financial resources and physical property, which is used in

9 transporting and treating Defendants' Medi-Cal clients at a financial loss, a violation

10 of Plaintiffs' civil rights.

11

12

THIRD CLAIM FOR RELIEF

13

14

VIOLATION OF EQUAL PROTECTION

FOURTEENTH AMENDMENT TO THE U.S. CONSTITUTION,

15

42 u.s.c. § 1983

16

82. Paragraphs 1 through 81 are incorporated by reference as if fully set forth

17 herein.

18

83. Defendants implement Welfare & Institutions Code, Section

19 14105.94(b)(l)-(3), which allows "eligible providers" of ground emergency medical

20 transportation services to receive additional reimbursements above the woefully low

21 Medi-Cal. reimbursement rate. Providers are "eligible" for the additional

22 reimbursement if they (1) provide ground emergency medical transportation, (2) are

23 enrolled as Medi-Cal providers, and (3) are owned and operated by a public fire

24 protection district. "Eligible providers" receive 50% of the difference between

25 Defendants' reimbursement amount and the actual cost of the service.

26

84. Defendants claim that, "fire departments are an essential part of the

27 health care safety net and are unique because of the mandate to respond, treat and

28 transport all emergency patients without exception and without regard to a patient's

22

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 23 of 35 Page ID #:946

1 ability to pay." (Legislative comments, Assembly Third Reading, AB 678 (Pan), as 2 amended May 27, 2011, p.2.)

3

85. In spite of Plaintiffs' identical obligations, the law mandates unequal

4 treatment of them because they are not eligible to receive the same additional

5 reimbursements as fire departments for performing the same emergency medical

6 transports. Defendants' conduct has caused a violation of Plaintiffs' rights to be 7 treated equally under the law.

8

86. In addition, under the State Plan, a wide range of medical services are

9 provided to Medi-Cal beneficiaries. Medical transportation is assured under the State

10 Plan (State Plan, Section 3.l(c)(1) and Attachment 3.1-D) and the state plan must

11 "[d]escribe the policy and the methods to be used in setting payment rates for each

12 type of service included in the State's Medicaid program." (42 C.F .R. Section

13 447.201.)

14

87. The State Plan provides specific reimbursement methods to be used for

15 medical transportation services (State Plan, Attachment 4.19-B), and for other types of

16 services. For example, specific methodology for determining reimbursement rates is

17 provided for durable medical equipment (Attachment4.19-B, page 3a), Targeted Case

18 Management Services (Attachment 4.19-B, page 5a), Federally Qualified Health

19 Centers and Rural Health Clinics (Attachment 4.19-B, page 6), Drug Medical services

20 (Attachment 4.19-B, page 38), and numerous other medical services (see Attachment 21 4.19-B).

22

88. Defendants have complied with California and federal laws when setting

23 Medi-Cal reimbursement rates for providers other than emergency medical

24 transportation services providers.. For example, pursuant to the requirements of

25 Attachment 4.19-B, in 2003,2004 and 2007, Defendants conducted rate studies

26 regarding the cost and market price of durable medical equipment and supplies that

27 resulted in reimbursement rates that are equal to "[t]he acquisition cost plus a 67%

28 markup" (Attachment 4.19-B, page 3e) or to "[t]he acquisition cost plus a 23%

23

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 24 of 35 Page ID #:947

1 markup" (Attachment 4.19-B, page 3f). In addition, in 2004, pursuant to the

2 requirements of Attachment 4.19-B, in 2004, Defendants established reimbursement

3 rates for case management services "on the basis of historical costs" (Attachment

4 4.19-B, page Sa). In fact, Defendants' State Plan is replete with instances oftheir

5 compliance with their rate-setting policies and procedures for providers other than

6 emergency transportation services providers. Many of Defendants' policies even

7 allow providers to negotiate reimbursement rates with Defendants.

8

89. There is no legitimate state end served by Defendants' compliance with

9 the requirements of 42 C.F.R. 447.201 (requiring State plan to set forth policy and

10 methods used in setting payment rates) for certain services and their refusal to comply

11 with it for emergency medical transportation services, or with Defendants' compliance

12 with some of their own rate-setting provisions, but not others. Non-emergency service

13 providers can negotiate payment rates with Defendants because they can choose not to

14 treat Defendants' Medi-Cal clients. Defendants are aware that because of the

15 emergency nature of their work and the statutory provisions designed to assist all

16 persons in· need of emergency assistance, Plaintiffs cannot choose to decline to

17 provide service to their clients. Consequently, by arbitrarily ignoring some provisions

18 of their policies, procedures and regulations, Defendants treat Plaintiffs differently

19 than other providers: Defendants reimburse Plaintiffs approximately 20% of their cost

20 to provide service to their Medi-Cal clients, but reimburse other providers, such as the

21 hospital to which Plaintiffs deliver a Medi-Cal client, or the specialist that treats the

22 Medi-Cal client, amounts that not only cover those providers' costs, but that provide

23 them with a profit. The result is that Defendants' actions cause economic injury to be

24 disproportionately concentrated on a few persons, in violation of their Constitutional

25 rights. Moreover, Plaintiffs' investment backed expectations and subsequent business

26 and operational decisions have been, and continue to be, based on the policies,

27 procedures and regulations established by Defendants that guarantee Plaintiffs a \.
28

24

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 25 of 35 Page ID #:948

1 minimum reimbursement of their costs in exchange for providing services to

2 Defendants' Medi-Cal beneficiaries.

3

90. Defendants' refusal to comply with state or federal law, including

4 Defendants' own regulations, when setting reimbursement rates for emergency

5 medical transportation services providers does not rationally relate to any public

6 purpose. The refusal is contrary to 42 U.S.C. 1396 et seq., which requires Defendants

7 to provide medical transportation services to Medi-Cal recipients and to reimburse the

8 providers of those services pursuant to a fair process. Defendants' refusal is contrary

9 to its own policy and regulations as well as California law, which, on its face,

10 demonstrates that Defendant's actions serve no legitimate state end. In fact,

11 Defendants' refusal and failure to comply with their own policies and procedures as

12 well as state and federal law places all Californians at risk by weakening the medical

13 transportation services industry as a whole by forcing Plaintiffs to subsidize Medi-Cal

14 with their private funds. This causes service providers to cut back on personnel,

15 training, equipment and innovation to avoid going out of business. Defendants'

16 actions are reducing the overall quality of care that all Californians receive.

17

91. At a minimum, reimbursement rates must be determined by following the

18 four-step process set forth in Attachment4.19-B to the State Plan. Defendants have

19 failed to follow these steps in determining reimbursement rates for Plaintiffs.

20 However, several types of medical services are afforded the required processes under

21 the State Plan for determination of their reimbursement rates. The distinctions drawn

22 in the Department's application of state and federal law bear no rational relationship to

23 any legitimate state end.

24

92. Consequently, Plaintiffs are not afforded the same or similar protection

25 under the law as other Medi-Cal service providers and public fire department

26 ambulance services, in violation of their civil rights.

27

28

25

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 26 of 35 Page ID #:949

1

FOURTH CLAIM FOR RELIEF

2

3

VIOLATION OF SUBSTANTIVE DUE PROCESS

FOURTEENTH AMENDMENT TO THE U.S. CONSTITUTION,

4

42 u.s.c. § 1983

5

· 93. Paragraphs 1 through 92 are incorporated by reference as if fully set forth

6 herein.

7

94. Plaintiffs have a protected property interest in their private funds and

8 property.

9

95. Defendants' actions of promulgating Section 51527 and its subsequent

10 amendments are arbitrary and capricious conduct that shocks the conscience because

11 Defendants refuse to comply with guarantees they made in exchange for receiving

12 federal money that was intended by the federal government to be paid to Plaintiffs for

13 the services they rendered to Medi-Cal beneficiaries; because Defendants use

14 unilateral bargaining power to force Plaintiffs to use their private funds and property

15 to provide services to Medi-Cal; because Defendants, in violation of federal and state

16 law, unilaterally, without supporting evidence of what the provision of the services

17 costs Plaintiffs, set the rates at which Plaintiffs are reimbursed at a ridiculously low

18 level; because despite the fact that Defendants themselves developed and submitted

19 their rate setting procedures to the federal government to obtain approval of their State

20 Plan, Defendants have never, and continue to refuse to follow their own procedures to

21 establish fair reimbursement rates for the services provided by Plaintiffs. Defendants

22 have admitted to Plaintiffs that the rates in Section 51527 are ridiculously low, but

23 because Plaintiffs are required by California law to transport their Medi-Cal clients

24 regardless of the reimbursement Plaintiffs receive, they have no reason to establish

25 fair rates for Plaintiffs.

26

96. Moreover, Defendants' conduct is arbitrary and capricious conduct that

27 shocks the conscience because they have refused to follow their own policies and

28 procedures--policies and procedures that they established and communicated to

26

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 27 of 35 Page ID #:950

1 Plaintiffs as the policies and procedures that would be used to set emergency medical

2 transportation service reimbursement rates. Specifically, Defendants have refused,

3 and continue to refuse, to follow the policies and procedures set out in Attachment

4 4.19-B to the State Plan. Defendants' refusal to follow Attachment 4.19-B has

5 resulted in a complete lack of relationship between the amounts Defendants reimburse

6 Plaintiffs to the costs incurred by Plaintiffs to provide the service. In fact, Defendants

7 reimburse Plaintiffs at a rate that is approximately 20% of the actual cost of providing

8 the service to Defendants' beneficiaries. The issue is not one of lost profits, but rather

9 it is cash out-of-pocket and the use of tangible property for each transport of

10 Defendant's Medi-Cal beneficiaries that is beingcompelled by Defendants.

11

97. Additionally, Defendants' conduct is arbitrary and capricious conduct

12 that shocks the conscience because Defendants are aware that Plaintiffs have no

13 bargaining power, in that Plaintiffs cannot decline to participate in Plaintiffs Medi-

14 Cal program because of the emergency nature of the work Plaintiffs perform.

15 Defendants use this unfair advantage to deprive Plaintiffs of their rights by forcing

16 them to subsidize their public assistance program.

17

98. Plaintiffs' constitutionally protected property and due process rights have

18 been, and continue to be adversely affected by Defendants' arbitrary, capricious and

19 shocking conduct.

20

99. There is no legitimate public interest served by Defendants' refusal to

21 follow the required procedures to determine reimbursement rates for medical

22 transportation services, particularly in light of the fact that Defendants themselves

23 developed the procedures as a way to provide a service to the public. Defendants'

24 failure to comply with their own procedures and federal law harms all Californians

25 because it weakens the entire medical transportation services industry by forcing

26 providers to shift funds away from innovation and improvements to subsidize

27 Defendants' program. Simply put, Defendants' actions have reduced the overall

28 quality of emergency medical transportation services that all Californians receive.

27

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 28 of 35 Page ID #:951

1

100. Consequently, Plaintiffs have been denied their right to substantive due

2 process, a violation of their civil rights.

3

4

FIFTH CLAIM FOR RELIEF

5

6

VIOLATION OF THE CONTRACT CLAUSE

ARTICLE 1, SECTION 10, CLAUSE 1 OF THE U.S. CONSTITUTION

7

8

101. Paragraphs 1 through 100 are incorporated by reference as if fully set

9 forth herein.

10

102. Article 1, Section 10, Clause 1 ofthe United States Constitution states

11 that "[n]o State shall ... pass any ... Law impairing the Obligation of Contracts."

12

103. Plaintiffs have entered into contracts with cities, counties and other

13 special districts for the provision of emergency medical transportation services.

14 Because of the serious nature of treating and transporting people whose lives are at

15 · risk, no company may provide emergency transportation services in California

16 without the consent of the governing body in the jurisdiction in which the services are

17 being provided. That consent is given only in the form of a fully exclusive or semi-

18 exclusive contract for services. Consequently, the only way for Plaintiffs to conduct

19 their business is by and through contractual agreements that cover specific geographic

20 areas. With the exception of some publicly operated emergency transportation

21 services, without the existence of these contracts, no Californian would receive

22 emergency transportation services when requesting assistance from their local 9-1-1

23 service.

24

104. Plaintiffs obtained their service contracts by participating in a

25 governmental approval process specified and administered by the entities awarding

26 the contracts. Each awarding entity specifies the services that must be provided by the

27 organization selected to perform the contract. In addition, the awarding entity requires

28 that the provider meet or exceed specific standards of service in the performance of

28

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 29 of 35 Page ID #:952

1 the contract. Those standards include specifications for 9-1-1 dispatch facilities, 9-1-1

2 call response times, number and type of ambulance vehicles, ambulance response

3 times, level of care, ambulance personnel certification and experience levels, medical

4 supervision levels, ongoing personnel training and quality assurance and quality

5 improvement plans. Each awarding entity also requires that providers specify the

6 maximum price they will charge for an emergency transport.

7

105. Plaintiffs set their prices based on a careful evaluation of the resources

8 needed to meet each requirement set forth by the awarding entity. Plaintiffs expect, at

9 a minimum, that persons and entities such as Defendants will comply with California

10 and federal law related to the provision of their services. That expectation is factored

11 into Plaintiffs' prices. Consequently, pursuant to the existence of California's State

12 Plan, and Attachment 4.19-B in particular, Plaintiffs bid on service contracts with the

13 expectation that they will earn enough money to cover the basic operational costs

14 incurred transporting Defendants' Medi-Cal beneficiaries. After being awarded a

15 contract, Plaintiffs are required to meet or exceed every term of the contract. To

16 protect the safety ofall Californians in emergency situations, if Plaintiffs do not meet

17 or exceed every contract term, their contracts are subject to revocation by the

18 awarding entity and Plaintiffs can be subject to regulatory and financial penalties.

19

106. Section 51527 ofthe California Code ofRegulations and its subsequent.

20 amendments, as promulgated by Defendants, have substantially impaired Plaintiffs'

21 existing contracts with various cities, counties and other special districts by forcing

22 Plaintiffs to use the funds earned through their performance of the contracts to

23 subsidize Defendants' Medi-Cal program. Plaintiffs' contracts are worth significantly

24 less than they were prior to Defendants' enactment of Section 51527 and its

25 subsequent amendments.

26

107. Section 51527 ofthe California Code ofRegulations and its subsequent

27 amendments, as promulgated by Defendants, do not serve an important government

28 · purpose. In fact, the legislation and its amendments are contrary to the law that

29

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 30 of 35 Page ID #:953

1 Defendants and their predecessors devised and drafted. Defendants state that their 2 "mission is to preserve and improve the health status of all Californians."4

3 Defendants' actions, however, endanger the health and safety of a significant portion

4 of the population of the State of California by stretching the state's emergency

5 response system so thin that the quality of service provided to all Californians has

6 been decreased.

7

108. Section 51527 of the California Code ofRegulations and its subsequent

8 amendments, as promulgated by Defendants, are not legitimate, are unreasonable and

9 are not necessary to serve any government purpose. The administrative record ofthe

10 legislation is devoid of any explanation or support for the rates contained in Section

11 51527. The rates were unilaterally set by Defendants, without explanation and

12 without a description of purpose.

13

109. In light ofthe surrounding circumstances, Section 51527 is not

14 reasonable. Defendants offer their clients several services under the Medi-Cal

15 program that are not required by federal law. At the same time, Defendants refuse to

16 promulgate Section 51527 in a manner that compensates Plaintiffs, at very least, for

17 the cost of the services they provide to Defendants' clients. Defendants' actions have

18 imposed a drastic impairment of Plaintiffs' contracts by significantly diminishing their

19 economic value when Defendants could take a more moderate course that would serve

20 their purposes equally well. For example, Defendants can use a small portion of the

21 State's Medi-Cal budget that is currently used for non-emergency transportation

22 services and other voluntary services to fund emergency transportation services at a

23 level that at least covers Plaintiffs costs of providing the services. Emergency

24 transportation services are exponentially more important to the health and safety of all

25 Californians than are non-emergency services.

26

27

28
4 http://www.dhcs.ca.gov/Pages/AboutUs.aspx
30

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 31 of 35 Page ID #:954

1

110. Defendants obtain a significant benefit from the illegal enactment of

2 Section 51527 and its amendments. By underpaying Plaintiffs, Defendants are able to

3 take tens of millions of dollars each year from Plaintiffs for their personal use.

4

5

SIXTH CLAIM FOR RELIEF

6

7

VIOLATION OF INTERSTATE COMMERCE CLAUSE

ARTICLE I, SECTION 8, CLAUSE 3 OF THE U.S. CONSTITUTION

8

9

111. Paragraphs 1 through 110 are incorporated by reference as if fully set

10 forth herein.

11

112. Pursuant to California and federal law, Medi-Cal recipients are medically

12 insured throughout the United States. Additionally Plaintiffs are required by law to

13 treat and transport individuals who are insured by Medi-Cal even if those services are

14 rendered outside of California. Defendants' Medi-Cal clients regularly request

15 assistance when traveling to, or living in, Nevada and Oregon. Plaintiffs are

16 compelled to provide services to them. Instead of receiving adequate compensation

17 for out-of-state emergency medical treatment and transportation of Medi-Cal

18 recipients, Plaintiffs are only compensated approximately 20% of the cost of

19 providing the service by the State of California. Thus, neighboring states and their

20 residents, including Plaintiffs, are compelled to use resources to support California's

21 Medi-Cal program.. This forced subsidization is a substantial impairment of interstate 22 commerce.

23

113. Article I, Section 8, Clause 3 ofthe United States Constitution vests

24 Congress with the power to regulate commerce among the several states. The

25 Interstate Commerce Clause was drafted to maintain a national economic union

26 unfettered by state-imposed limitations on interstate commerce as well as to allow

27 individual states to be autonomous within their boundaries. Moreover, the Interstate

28 Commerce Clause protects against inconsistent legislation arising from the projection

31

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 32 of 35 Page ID #:955

1 of one state's regulatory regime into the jurisdiction of another state. Defendants'

2 unilateral decision to substantially underpay Plaintiffs treating Medi-Cal recipients

3 who seek care outside of California forces those states to submit to an invalid and

4 illegal California law.

5

114. Simply put, California is regulating the prices of out-of-state transactions

6 in clear violation of the Interstate Commerce Clause. First, this enactment applies to

7 commerce that takes place wholly outside the State of California, specifically

8 establishing a scale of prices for use in both Nevada and Oregon: Second, the

9 practical effect of this enactment directly controls conduct which is occurring wholly

10 outside the State of California. Third, if all fifty states enacted similar legislation,

11 emergency medical transportation services would be significantly harmed or

12 eliminated.

13

115. Section 51527 and its subsequent amendments, as promulgated by

14 Defendants, clearly discriminates in favor of California interests. Defendants'

15 motives for not paying Plaintiffs just compensation for treating and transporting their

16 Medi-Cal clients is economic protectionism. These enactments have the effect of

17 favoring in-state economic interests by reducing the cost of health care for poor and

18 indigent Californians over the economic interests of other states which are forced t.o

19 subsidize Medi-Cal.

20

116. Furthermore, less discriminatory alternatives exist to effectively care for

21 all California residents. For example, Defendants compensate non-emergency

22 transportation services at a substantially higher rate than Plaintiffs receive for

23 emergency transportation services. While it is perplexing as to why mandatory

24 emergency transportation is somehow less costly than voluntary non-emergency

25 transportation services, clearly funds from voluntary services could be used to

26 compensate Plaintiffs.

27

11 7. Paying Plaintiffs twenty cents on the dollar for each emergency

28 transportation service rendered does not promote the welfare and safety of the people

32

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 33 of 35 Page ID #:956

1 of California, in fact, such a cost-cutting measure hinders Plaintiffs ability to maintain

2 its current emergency response capabilities. Furthermore, the burden that this

3 enactment places on interstate commerce is clearly excessive in relation to its putative

4 local benefits. By refusing to pay fair market value for services rendered, Plaintiffs

5 are forced to charge a greater rate for its services to non Medi-Cal recipients. In sum,

6 California's self-interested legislation is driving up the cost of health care throughout

7 the United States.

8

9

PRAYER

10

Plaintiffs pray for:

11

1. An order permanently enjoining Defendants from reimbursing Plaintiffs

12 less than their "usual charges" for the services they provide to Defendant's Medi-Cal

13 clients;

14

2. Declaratory relief consistent with the injunction;

15

3. Restitution;

16

4. For compensatory damages from Defendants in their personal capacities

17 in an amount according to proof at trial;

18

5. Attorney's fees as allowed by law;

19

6. Costs of suit and pre-judgment interest;

20

7. For punitive damages against the Defendants in their individual

21 capacities;

22

8. Any other relief the Court may deem proper and equitable.

23

24 Dated: September 21, 20 12
25
26 27 28

MICHELMAN & ROBINSON LLP
-----=..:;:.__VMv~--­
By: Andrew H. Selesnick Kevin R. Warren Attorneys for Plaintiffs
33

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 34 of 35 Page ID #:957

1

DEMAND FOR JURY TRIAL

2

Plaintiffs hereby demand a trial by jury.

3

4 Dated: September 20, 2012
5 6 7 8 9

MICHELMAN & ROBINSON LLP
By:-------=-~~/Andrew H. Selesnick
Kevin R. Warren
Attorneys for Plaintiffs

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

34

Case 2:10-cv-04182-CAS-MAN Document 67 Filed 09/20/12 Page 35 of 35 Page ID #:958

1

PROOF OF SERVICE

Morris Berkowitz, et al. v. Nirav R. Shaw, M.D., M.P.H.

2

USDC, SDNY Case No.12 CV 5227 (JSR)

3 STATE OF CALIFORNIA, COUNTY OF LOS ANGELES
4
I am employed in the County of Los Angeles, State of California. I am over the 5 age of 18 and not a party to the within action. My business address is 15760 Ventura
Boulevard, 5th Floor, Encino, California 91436.
6

7

On September 20, 2012, I served the foregoing document(s) described as

8 follows: FIRST AMENDED COMPLAINT FOR INJUNCTIVE RELIEF, DECLARATORY RELIEF AND DAMAGES; JURY TRIAL DEMANDED, on

9 the interested parties in this action, by placing a true copy thereof enclosed in a sealed

10 envelope(s) addressed to the following addressee(s):

11 Hadara Stanton CAAG- Office of the Attorney General
12 California Department of Justice
455 Golden Gate Avenue, Suite 11000 13 San Francisco, CA 94102

14

[ ] (BY MESSENGER SERVICE): I served the documents by placing them in

15

an envelope or package addressed to the person at the addresses listed above

16

and providing them to a professional messenger service for service. (See

Declaration ofMessenger below).
17

18 [ X ] BY FEDERAL EXPRESS/STANDARD OVERNIGHT MAIL: I caused the

above-described document to be served on the interested parties noted above by

19

Federal Express/Standard Overnight Mail.

20 [ X ] FEDERAL: I hereby certify that I am employed in the office of a member of

21

the Bar of this Court at whose direction the service was made.

22

I declare under penalty of perjury under the laws of the State of California, that

23 the above is true and correct.

24

25

26

27

28

35

 
 Case 2:10-cv-04182-CAS-MAN Document 127 Filed 07/28/14 Page 1 of 12 Page ID #:3099

UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA

Case No. Title

CIVIL MINUTES - GENERAL

2:10-cv-04182-CAS-MANx

Date July 28, 2014

SIERRA MEDICAL SERVICES ALLIANCE, ET AL. V. DAVID MAXWELL-JOLLY, ET AL.

Present: The Honorable CHRISTINA A. SNYDER

CATHERINE JEANG Deputy Clerk

LAURA ELIAS Court Reporter / Recorder

N/A Tape No.

Attorneys Present for Plaintiffs:

Attorneys Present for Defendants

Kevin Warren

Hadara Stanton

Proceedings:

DEFENDANTS’ MOTION FOR SUMMARY JUDGMENT (Dkt. 95, filed October 25, 2013)

I. INTRODUCTION
On June 4, 2010, plaintiffs Sierra Medical Services Alliance (“SEMSA”), Care Flight, Riggs Ambulance Service, Inc. (“Riggs”), American Ambulance Service, Inc., Schaefer Ambulance Service, Inc., American Ambulance of Visalia, Desert Ambulance Service, San Luis Ambulance Service, Inc., First Responder Emergency Medical Services, Inc., Imperial Ambulance Services, Inc., Exeter District Ambulance, Sierra Lifestar, Inc., d.b.a. Lifestar Ambulance, Del Norte Ambulance, Inc., Piner’s Ambulance, Inc., American Legion Post 108 Ambulance Service, Progressive Ambulance, Inc., d.b.a, Liberty Ambulance, Hall Ambulance Service, Inc., City Ambulance of Eureka, Inc., Patterson District Ambulance, K.W.P.H. Enterprises, d.b.a., American Ambulance, Community Ambulance Services, Inc., Sierra Ambulance Service, Inc., Care Ambulance Service, Inc., Delano Ambulance Service, Inc., Kern Emergency Medical Transportation Corporation, d.b.a., Kern Ambulance, Manteca District Volunteer Ambulance Service,1 d.b.a. Manteca District Ambulance Service, filed this action against David MaxwellJolly, Former Director of the California Department of Health Care Services (the “Department”).2 The Department is a California agency charged with the administration

1 On July 18, 2014, Manteca District Ambulance Service voluntarily dismissed its claims. Dkt. 125.

2 Toby Douglas, the current director of the Department, was automatically

substituted for his predecessor in this action pursuant to Federal Rule of Civil Procedure

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Case 2:10-cv-04182-CAS-MAN Document 127 Filed 07/28/14 Page 2 of 12 Page ID #:3100

UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA

Case No. Title

CIVIL MINUTES - GENERAL

2:10-cv-04182-CAS-MANx

Date July 28, 2014

SIERRA MEDICAL SERVICES ALLIANCE, ET AL. V. DAVID MAXWELL-JOLLY, ET AL.

of California’s Medicaid program, Medi-Cal. Plaintiffs provide medical transportation services to Medi-Cal beneficiaries in 31 of 58 California counties. In the instant action, plaintiffs seek to enjoin defendants from enforcing section 51527 of the California Code of Regulations (“section 51527”).
Plaintiffs’ operative first amended complaint (“FAC”) asserts the following claims for relief, all pursuant to the U.S. Constitution: (1) taking private property for public use without just compensation in violation of the Fifth Amendment; (2) procedural due process violations under the Fifth and Fourteenth Amendments; (3) equal protection violations pursuant to the Fourteenth Amendment; (4) substantive due process violations under the Fourteenth Amendment; (5) violations of the Contract Clause, Art. I, § 10; and (6) violations of the Interstate Commerce Clause, Art. I, § 8.3 Plaintiffs seek an order “enjoining defendants from reimbursing plaintiffs less than their ‘usual charges’ for the services they provide” and compensatory damages from defendants in their individual capacities in the amount of $180 million. FAC at 33.
Defendants moved for summary judgment on plaintiffs’ FAC on October 25, 2013. Dkt. 95. Plaintiffs opposed the motion on June 6, 2014, dkt. 119, and defendants replied on July 11, 2014. Dkt. 123. On July 28, 2014, the Court held a hearing. After considering the parties’ arguments, the Court finds and concludes as follows.
II. BACKGROUND
Medicaid is a joint-federal state program that provides federal funding for the provision of medical care to needy individuals, subject to various conditions. To participate in Medicaid, a state must submit a “state plan” that attests to the state’s

25(d).

3 By order dated December 10, 2012, the Court dismissed all of the claims brought

by plaintiffs SEMSA, Riggs, and Careflight, except for their equal protection claims. Dkt.

77. The Court did not dismiss the claims as brought by the other plaintiffs. Id. The

Court also dismissed the FAC’s claims against Maxwell-Jolly and Douglas in their

individual capacities. Id.

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Case 2:10-cv-04182-CAS-MAN Document 127 Filed 07/28/14 Page 3 of 12 Page ID #:3101

UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA

Case No. Title

CIVIL MINUTES - GENERAL

2:10-cv-04182-CAS-MANx

Date July 28, 2014

SIERRA MEDICAL SERVICES ALLIANCE, ET AL. V. DAVID MAXWELL-JOLLY, ET AL.

compliance with federal regulatory requirements. See 42 C.F.R. § 430.10. As relevant here, federal law requires that a state plan must “[s]pecify that the Medicaid agency will ensure . . . necessary transportation for recipients to and from providers” and “[d]escribe the methods that the agency will use to meet this requirement.” 42 C.F.R. § 431.53.

According to the State Plan, payment rates for these medical transportation services are set at either the “lesser of usual charges or the limits specified in the California Code of Regulations.” Statement of Undisputed Facts (“SUF”) ¶ 10. The State Plan describes a particular methodology for determining these payment limits or reimbursement rates. Id. ¶ 11. The reimbursement rates for medical transportation services are set forth in section 51527 of the California Code of Regulations. However, plaintiffs assert that defendants set these payment rates without a proper evidentiary base or pertinent input from the public, in violation of the State Plan and California law. Statement of Genuine Disputes (“SGD”) ¶ 36. In addition, because medical transportation providers must respond to every emergency call in their jurisdiction, they cannot choose to decline to provide service to Medi-Cal clients despite the unreasonably low reimbursement rates. Id. ¶ 24. As such, plaintiffs contend that defendants’ “unilaterally” setting these arbitrarily low payment rates for medical transportation services deprived them of their private property without just compensation and violated their due process rights, among other violations of their federal constitutional rights.

III. LEGAL STANDARD

Summary judgment is appropriate where “there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law.” Fed. R. Civ. P. 56(a). The moving party bears the initial burden of identifying relevant portions of the record that demonstrate the absence of a fact or facts necessary for one or more essential elements of each claim upon which the moving party seeks judgment. See Celotex Corp. v. Catrett, 477 U.S. 317, 323 (1986).

If the moving party meets its initial burden, the opposing party must then set out

specific facts showing a genuine issue for trial in order to defeat the motion. Anderson v.

Liberty Lobby, Inc., 477 U.S. 242, 250 (1986); see also Fed. R. Civ. P. 56(c), (e). The

nonmoving party must not simply rely on the pleadings and must do more than make

“conclusory allegations [in] an affidavit.” Lujan v. Nat’l Wildlife Fed’n, 497 U.S. 871,

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UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA

Case No. Title

CIVIL MINUTES - GENERAL

2:10-cv-04182-CAS-MANx

Date July 28, 2014

SIERRA MEDICAL SERVICES ALLIANCE, ET AL. V. DAVID MAXWELL-JOLLY, ET AL.

888 (1990); see also Celotex, 477 U.S. at 324. Summary judgment must be granted for the moving party if the nonmoving party “fails to make a showing sufficient to establish the existence of an element essential to that party’s case, and on which that party will bear the burden of proof at trial.” Id. at 322; see also Abromson v. Am. Pac. Corp., 114 F.3d 898, 902 (9th Cir. 1997).

In light of the facts presented by the nonmoving party, along with any undisputed facts, the Court must decide whether the moving party is entitled to judgment as a matter of law. See T.W. Elec. Serv., Inc. v. Pac. Elec. Contractors Ass’n, 809 F.2d 626, 631 & n.3 (9th Cir. 1987). When deciding a motion for summary judgment, “the inferences to be drawn from the underlying facts . . . must be viewed in the light most favorable to the party opposing the motion.” Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 587 (1986) (citation omitted); Valley Nat’l Bank of Ariz. v. A.E. Rouse & Co., 121 F.3d 1332, 1335 (9th Cir. 1997). Summary judgment for the moving party is proper when a rational trier of fact would not be able to find for the nonmoving party on the claims at issue. See Matsushita, 475 U.S. at 587.

IV. ANALYSIS

A. The Eleventh Amendment

At the outset, defendants argue that plaintiffs’ case is barred by the Eleventh Amendment. The Eleventh Amendment prohibits federal jurisdiction over suits against a state or state agency unless the state or agency consents to the suit. See Seminole Tribe of Florida v. Florida, 517 U.S. 44, 53 (1996); Pennhurst State School & Hosp. v. Halderman, 465 U.S. 89, 100 (1984); Quern v. Jordan, 440 U.S. 332, 342 (1979). State officers acting in their official capacities receive the same immunity as the government agency that employs them. Hafer v. Melo, 502 U.S. 21, 23 (1991). A state official is not immune, however, when sued in an official capacity for prospective relief. Ex Parte Young, 209 U.S. 123 (1908); Edelman v. Jordan, 415 U.S. 651, 664 (1974); Will v. Michigan Dep’t State Police, 491 U.S. 58, 90-91 (1989).

Defendants assert that plaintiffs claims are barred because they seek monetary relief, in the form of the increased reimbursements that plaintiffs believe they were entitled to over the past decade. Even assuming that the Eleventh Amendment does apply

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UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA

Case No. Title

CIVIL MINUTES - GENERAL

2:10-cv-04182-CAS-MANx

Date July 28, 2014

SIERRA MEDICAL SERVICES ALLIANCE, ET AL. V. DAVID MAXWELL-JOLLY, ET AL.

here, however, the Eleventh Amendment would at most circumscribe the relief available, rather than entirely foreclose plaintiffs’ claims. This is so because plaintiffs seek prospective injunctive relief in the form of an “order permanently enjoining Defendants from reimbursing [p]laintiffs less than their ‘usual charges’ for the services they provide to [d]efendant’s Medi-Cal clients.” FAC at 33; cf. Cardenas v. Anzai, 311 F.3d 929, 935 (9th Cir. 2002) (explaining that “an injunction requiring a state official to conform his administration of a federal welfare program to federal law was prospective and thus not barred by the Eleventh Amendment, but that an order that the official remit the amounts he had wrongfully withheld in the past was retrospective and thus impermissible”). Accordingly, the Court concludes that the Eleventh Amendment does not conclusively bar plaintiffs’ claims. Because the Court further concludes that summary judgment must be granted against plaintiffs on the merits of the FAC, the Court does not reach the question of whether the Eleventh Amendment forecloses plaintiffs from receiving certain remedies.
B. Takings Claim
Plaintiffs assert that section 51527 is an unconstitutional taking of their private property, in violation of the Fifth Amendment. The “Takings Clause” of the Fifth Amendment provides that private property shall not “be taken for public use, without just compensation.” U.S. Const. amend. V. “In order to state a claim under the Takings Clause, a plaintiff must first demonstrate that he possesses a ‘property interest’ that is constitutionally protected.” Turnacliff v. Westly, 546 F.3d 1113, 1118-19 (9th Cir. 2008) (internal citations omitted).
Plaintiffs’ takings claim fails as a matter of law, because plaintiffs do not have a property interest in the reimbursement rates set by section 51527. A virtually identical takings claim was squarely rejected by the Ninth Circuit in Managed Pharmacy Care v. Sebelius, 716 F.3d 1235 (9th Cir. 2013). In Managed Pharmacy Care, the Ninth Circuit held that “[b]ecause participation in Medicaid is voluntary, . . . . providers do not have a property interest in a particular reimbursement rate.” Id. at 1252. This conclusion disposes of plaintiffs’ claim here: without a property interest in the reimbursement rate, nothing has been taken from plaintiffs, and there can be no violation of the Fifth Amendment.

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Case 2:10-cv-04182-CAS-MAN Document 127 Filed 07/28/14 Page 6 of 12 Page ID #:3104

UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA

Case No. Title

CIVIL MINUTES - GENERAL

2:10-cv-04182-CAS-MANx

Date July 28, 2014

SIERRA MEDICAL SERVICES ALLIANCE, ET AL. V. DAVID MAXWELL-JOLLY, ET AL.

Plaintiffs attempt to distinguish Managed Pharmacy Care by arguing that they are not asserting a takings claim based on reimbursement rates, but instead based “upon the fact that their private property is repeatedly taken from them without just compensation because they have no real option to cease providing services to Medi-Cal beneficiaries.” Opp. 9. Specifically, plaintiffs argue that California law requires them to treat all patients within their operating area, without regard to their Medi-Cal status or ability to pay. Plaintiffs argue that defendants have taken advantage of plaintiffs’ legal obligation to provide care by setting rates for plaintiffs at much lower rates than similarly situated nonemergency providers who are under no obligation to provide services to Medi-Cal beneficiaries.

The Court finds this argument unpersuasive. First, Managed Pharmacy Care expressly held that providers cannot state a takings claim even when they are under a legal obligation to provide care. The hospital at issue in Managed Pharmacy Care asserted a takings claim based in part on “state laws restricting the expulsion of patients from skilled nursing facilities.” Id. Notwithstanding these obligations to provide care, the Ninth Circuit held that the providers nonetheless lacked a property interest in a particular level of reimbursement because the providers “can hardly expect that reimbursement rates will never change.” Id. This conclusion applies with even greater force here, where the pertinent reimbursement rates have remained fixed since 2002 and it is plaintiffs who seek to increase the rates. Zaretsky Decl. ¶ 6.

Second, and more importantly, even if this Court were to assume that plaintiffs’ obligation to provide care could create a takings claim, plaintiffs would still not have a takings claim based on the reimbursement rates set by section 51527. Instead, the taking at issue would be the law obligating plaintiffs to, as they put it, use their “ambulances, equipment, medical supplies, fuel, wages . . . etc. . . . [to] provid[e] medical transportation services to Medi-Cal beneficiaries.” Opp. 11. However, plaintiffs do not identify, much less assert a takings claim against, the statute or regulation which obligates them to provide these services. See PSGD ¶ 30 (generally describing legal obligations without citing any specific statute or regulation). Indeed, there is at least some suggestion in plaintiffs’ opposition papers that these obligations may be a matter of contract. Staffan Decl. ¶ 10. In any event, plaintiffs cannot assert that section 51527 works a taking by citing an obligation imposed from some other source. Accordingly, the Court concludes that plaintiffs’ takings claim fails as a matter of law.

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Case 2:10-cv-04182-CAS-MAN Document 127 Filed 07/28/14 Page 7 of 12 Page ID #:3105

UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA

Case No. Title

CIVIL MINUTES - GENERAL

2:10-cv-04182-CAS-MANx

Date July 28, 2014

SIERRA MEDICAL SERVICES ALLIANCE, ET AL. V. DAVID MAXWELL-JOLLY, ET AL.

C. Due Process

Plaintiffs assert that section 51527 deprives them of property without due process, in violation of the Fifth and Fourteenth Amendments. The due process clause of the Fourteenth Amendment prohibits the government from depriving persons of “life, liberty, or property, without due process of law.” U.S. Const. amend. XIV. Plaintiffs assert two variants of this claim: first as a “procedural due process” claim, second as a “substantive due process” claim. See Denney v. Drug Enforcement Admin., 508 F. Supp. 2d 815, 833 (E.D. Cal. 2007) (“The Due Process Clause guarantees two types of due process: procedural and substantive.”). Both theories, however, are predicated on the same underlying contention that defendants deprived plaintiffs of some liberty or property interest. See Buckingham v. Sec’y of U.S. Dep’t of Agric., 603 F.3d 1073, 1081 (9th Cir. 2010) (“To be entitled to procedural due process, a party must show a liberty or property interest in the benefit for which protection is sought.”); Nunez v. City of Los Angeles, 147 F.3d 867, 871 (9th Cir. 1998) (“To establish a substantive due process claim, a plaintiff must, as a threshold matter, show a government deprivation of life, liberty, or property.”). Accordingly, these claims fail for substantially the same reason as plaintiffs’ takings claim, namely that plaintiffs’ lack a property interest in the reimbursement rates set by section 51527. Without a property interest, plaintiffs have not been deprived of anything, and therefore their due process claims must fail as a matter of law.

D. Equal Protection

Plaintiffs contend that defendants’ failure to increase the reimbursment rate for

emergency transportation violates the equal protection clause of the Fourteenth

Amendment. “The Equal Protection Clause of the Fourteenth Amendment commands

that no State shall deny to any person within its jurisdiction the equal protection of the

laws, which is essentially a direction that all persons similarly situated should be treated

alike.” City of Cleburne v. Cleburne Living Center, 473 U.S. 432, 439 (1985) (internal

quotation marks and citation omitted). To establish a violation of equal protection, a

petitioner must show both that he was similarly situated to others who received

preferential treatment, Cleburne, 473 U.S. at 439, and that there was a discriminatory

motive or intent behind that different treatment. McLean v. Crabtree, 173 F.3d 1176,

1185 (9th Cir. 1999); Thomas v. Borg, 159 F.3d 1147, 1150 (9th Cir. 1998). A mere

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UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA

Case No. Title

CIVIL MINUTES - GENERAL

2:10-cv-04182-CAS-MANx

Date July 28, 2014

SIERRA MEDICAL SERVICES ALLIANCE, ET AL. V. DAVID MAXWELL-JOLLY, ET AL.

demonstration of inequality is not enough: “[t]here must be an allegation of invidiousness or illegitimacy in the statutory scheme before a cognizable [equal protection] claim arises.” McQueary v. Blodgett, 924 F.2d 829, 835 (9th Cir. 1991). Moreover, unless the alleged discrimination involves a suspect class of persons or a fundamental right, a challenged statute satisfies equal protection if it bears a rational relation to a legitimate governmental interest. See United States v. Klein, 860 F.2d 1489 (9th Cir. 1988), overruled on other grounds by United States v. Nordby, 225 F.3d 1053 (9th Cir. 2000)); City of New Orleans v. Dukes, 427 U.S. 297 (1976) (explaining that federal courts employ a presumption that governmental classifications do not violate the Equal Protection Clause unless they burden a suspect class or a fundamental interest).

Here, plaintiffs point to two different types of disparate treatment that they claim violates the Equal Protection Clause. First, plaintiffs argue that public ambulance providers are reimbursed at higher rates than private ambulance services like the plaintiffs. See Cal. Welf. & Inst. Code § 141.05.94(g). Because private ambulance providers are not a suspect class, this claim is tested under rational basis review: the difference in reimbursement rates must have a rational relation to a legitimate state interest. The Court concludes that under this “lenient standard,” San Antonio Indep. Sch. Dist. v. Rodriguez, 411 U.S. 1, 104 (1973), the difference in reimbursement rates between public and private ambulance providers does not violate the Equal Protection Clause. Under federal Medicare regulations, reimbursement of public providers, unlike reimbursement of private providers, counts toward the state’s obligation to pay a share of Medicare expenses. 42 C.F.R. § 433.51. From the state’s perspective, then, reimbursement of public emergency transportation is costless, as it will substitute dollar-for-dollar for Medicare expenses that the state would otherwise be obligated to pay. As the same cannot be said for reimbursement of private emergency transportation, structuring reimbursement rates to favor public entities is rationally related to a legitimate government purpose, namely maximizing California’s receipt of federal funds. Accordingly, the Court concludes that the discrespancy in reimbursement rates does not deny plaintiffs equal protection of the law.

Second, plaintiffs contend that, unlike the reimbursement rates of providers of

other types of medical services, the reimbursement rates for emergency medical

transportation have not been set and reviewed in accordance with state and federal law.

See Opp. 15 (“This is the basis for the equal protection claim, because [d]efendant does

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UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA

Case No. Title

CIVIL MINUTES - GENERAL

2:10-cv-04182-CAS-MANx

Date July 28, 2014

SIERRA MEDICAL SERVICES ALLIANCE, ET AL. V. DAVID MAXWELL-JOLLY, ET AL.

consider an evidentiary base for other providers, in contrast to arbitrarily and capriciously setting [p]laintiffs’ reimbursement rates.”). This claim is predicated on the underlying premise that the manner in which defendants set the reimbursement rates violated state and federal law. As such, this equal protection claim is nothing more than a statutory claim: plaintiffs contend that defendants followed the law for other medical providers, but not for them. But a “construction of the equal protection clause which would find a violation of federal right in every departure by state officers from state law is not to be favored.” Snowden v. Hughes, 321 U.S. 1, 11-12 (1944); see also Sylvia Dev. Corp. v. Calvert Cnty., Md., 48 F.3d 810, 825 (4th Cir. 1995) (“If disparate treatment alone were sufficient to warrant a constitutional remedy, then every blunder by a local authority, in which the authority erroneously or mistakenly treats an individual differently than it treats another who is similarly situated, would rise to the level of a federal constitutional claim.”).
This is all the more true here, where plaintiffs appear to rely on violations of statutes for which there may or may not be a private right of action. See, e.g., Developmental Servs. Network v. Douglas, 666 F.3d 540, 546 (9th Cir. 2011) (no private right of action to enforce provision of Medicare act); California Ass’n of Rural Health Clinics v. Douglas, 738 F.3d 1007, 1013 (9th Cir. 2013) (private right of action to enforce different provision of Medicare act). Plaintiff may not sidestep the private-rightof-action inquiry by bootstrapping their statutory claims through the Equal Protection Clause. Cf. dkt. 77 at 7 n.4 (rejecting defendants’ contention that plaintiffs lack a private right of action because “[u]nlike the challenges brought pursuant to the Supremacy Clause and Section 30(A) of the Medicaid Act, plaintiffs’ claims in this action are premised solely on violations of plaintiffs’ protected rights under the U.S. Constitution”). If plaintiffs wish to bring a statutory claim, they must do so explicitly. Accordingly, the Court concludes that plaintiffs’ claim under the Equal Protection Clause must fail.

E. Contracts Clause

The “Contracts Clause” provides that “[n]o State shall . . . pass any . . . law

impairing the Obligation of Contracts.” U.S. Const. art. I, § 10. Though written in

absolute terms, the Supreme Court narrowly construes the Contracts Clause to ensure that

local governments can effectively exercise their police powers. Seltzer v. Cochrane, 104

F.3d 234, 235 (9th Cir. 1996). State governmental entities “must possess broad power to

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Case 2:10-cv-04182-CAS-MAN Document 127 Filed 07/28/14 Page 10 of 12 Page ID #:3108
UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA

Case No. Title

CIVIL MINUTES - GENERAL

2:10-cv-04182-CAS-MANx

Date July 28, 2014

SIERRA MEDICAL SERVICES ALLIANCE, ET AL. V. DAVID MAXWELL-JOLLY, ET AL.

adopt general regulatory measures without being concerned that private contracts will be impaired, or even destroyed, as a result.” United States Trust Co. v. New Jersey, 431 U.S. 1, 22 (1977). However, a “higher level of scrutiny is required” when the legislative interference involves a public rather than a private obligation. Univ. of Haw. Prof’l Assembly v. Cayetano, 183 F.3d 1096, 1107 (9th Cir. 1999).

Here, plaintiffs assert that defendants’ failure to increase Medi-Cal reimbursement rates has impaired plaintiffs’ contracts with “various municipalities and special districts that require them to provide emergency service to all persons in need.” Opp. 17. In analyzing this claim, the Court begins with the threshold inquiry in all Contracts Clause cases: whether the state has substantially impaired a contractual relationship. This threshold inquiry “has three components: ‘whether there is a contractual relationship, whether a change in law impairs that contractual relationship, and whether the impairment is substantial.’” RUI One Corp. v. City of Berkeley, 371 F.3d 1137, 1147 (9th Cir. 2004) (quoting Gen. Motors Corp. v. Romein, 503 U.S. 181, 186 (1992)).
Plaintiffs meet the first prong of this threshold inquiry, as they contend—and defendants do not dispute—that plaintiffs have contracts with various cities, counties, and special districts. SGD ¶ 25. Defendants argue that these contracts do not qualify for protection under the Contracts Clause, because the Clause only prohibits interference with contracts between plaintiffs and the state, not contracts between plaintiffs and third parties. Defendants’ argument is misplaced: although the Contracts Clause requires a “higher level of scrutiny” when evaluating contracts involving a state, the Contracts Clause prohibits unjustified interference with all contracts, including contracts to which state is not a party. Cayetano, 183 F.3d at 1107.

However, plaintiffs’ Contracts Clause claim fails at the next step, as plaintiffs have not shown that defendants’ failure to increase the reimbursement rates has substantially impaired plaintiffs’ contracts with the cities and special districts. Plaintiffs concede that their contracts with these entities do not provide for plaintiffs to receive any reimbursement at all for the transportation of Medi-Cal patients. SGD ¶ 33. Instead, these contracts obligate plaintiffs to transport patients regardless of their Medi-Cal status, or ability to pay. Id. ¶ 28. Under the terms of these contracts, plaintiffs must transport Medi-Cal patients for free: plaintiffs receive their payment, if any, pursuant to separate Medi-Cal Provider Agreements, not their contracts with the cities and special districts.

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Case 2:10-cv-04182-CAS-MAN Document 127 Filed 07/28/14 Page 11 of 12 Page ID #:3109
UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA

Case No. Title

CIVIL MINUTES - GENERAL

2:10-cv-04182-CAS-MANx

Date July 28, 2014

SIERRA MEDICAL SERVICES ALLIANCE, ET AL. V. DAVID MAXWELL-JOLLY, ET AL.

Id. ¶ 33. In other words, the contracts at issue do not contain any provision that sets reimbursement rates for emergency medical transportation. But the Contracts Clause only subjects “state statutes that impair a specific (explicit or implicit) contractual provision to constitutional scrutiny.” RUI One Corp., 371 F.3d at 1151. Accordingly, defendants’ decision not to increase reimbursement rates cannot impair plaintiffs’ contracts with the cities and special districts, because those contracts do not provide for reimbursement. Plaintiffs’ Contracts Clause claim cannot survive summary judgment.

F. Commerce Clause

The Commerce Clause provides that “Congress shall have Power . . . [t]o regulate Commerce . . . among the several States.” U.S. Const., art. I, § 8, cl. 3. “This affirmative grant of power does not explicitly control the several states, but it ‘has long been understood to have a ‘negative’ aspect that denies the States the power unjustifiably to discriminate against or burden the interstate flow of articles of commerce.’” Rocky Mountain Farmers Union v. Corey, 730 F.3d 1070, 1087 (9th Cir. 2013) (quoting Or. Waste Sys., Inc. v. Dep’t of Envtl. Quality of State of Or., 511 U.S. 93, 98 (1994)); see also Nat’l Ass’n of Optometrists & Opticians v. Harris, 682 F.3d 1144, 1148 (9th Cir. 2012) (“Modern dormant Commerce Clause jurisprudence primarily “is driven by concern about economic protectionism—that is, regulatory measures designed to benefit in-state economic interests by burdening out-of-state competitors.” (quoting Dep’t of Revenue v. Davis, 553 U.S. 328, 337-38 (2008))). Plaintiff asserts that defendants have violated this “dormant” Commerce Clause, because Medi-Cal reimbursement rates set the payment level for non-California medical transportation firms, as well as for services provided to Medi-Cal recipents outside California.

This claim fails, for two reasons. First, the claim fails on the merits. Plaintiffs do

not dispute that section 51527 sets equal reimbursement rates for in-state and out-of-state

providers, as well as for services rendered in-state and out-of-state. Because section

51527 does not discriminate, it only violates the dormant Commerce Clause if it imposes

a burden on interstate commerce that is clearly excessive when measured against its local

benefits. See Rocky Mountain Farmers Union v. Corey, 730 F.3d 1070, 1087-88 (9th

Cir. 2013) (“Absent discrimination, we will uphold the law ‘unless the burden imposed

on [interstate] commerce is clearly excessive in relation to the putative local benefits.’”

(quoting Pike v. Bruce Church, Inc., 397 U.S. 137, 142 (1970))). But the record is devoid

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UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA

Case No. Title

CIVIL MINUTES - GENERAL

2:10-cv-04182-CAS-MANx

Date July 28, 2014

SIERRA MEDICAL SERVICES ALLIANCE, ET AL. V. DAVID MAXWELL-JOLLY, ET AL.

of any evidence that section 51526 “burdens” interstate commerce. At most, plaintiffs have provided evidence that section 51527 burdens particular emergency medical transportation providers, by not compensating them as well as they would prefer. And “the [Commerce] Clause protects the interstate market, not particular interstate firms, from prohibitive or burdensome regulations.” Exxon Corp. v. Governor of Maryland, 437 U.S. 117, 127-28 (1978); see also id. (“It may be true that the consuming public will be injured by the [regulation], but again that argument relates to the wisdom of the statute, not to its burden on commerce.”). In the absence of any showing that section 51527 actually interferes with interstate commerce, plaintiffs’ claim must fail. See Nat’l Ass’n of Optometrists, 682 F.3d at 1148 (“[A] state regulation does not become vulnerable to invalidation under the dormant Commerce Clause merely because it affects interstate commerce.”).
Second, there is a disconnect between plaintiffs’ claim and the relief sought. Even assuming that defendants’ regulation of Medi-Cal reimbursement rates did violate the dormant Commerce Clause, the conclusion that would follow would be that defendants lacked the authority to set reimbursement rates for providers and services outside California. Plaintiffs, however, seek not to preclude defendants from setting reimbursement rates, but rather an injunction ordering defendants to set those rates at a different level. Accordingly, the Court concludes that summary judgment is also appropriate because plaintiffs would not receive the relief they seek even if they prevailed on the merits of their claim.
V. CONCLUSION
In accordance with the foregoing, defendants’ motion for summary judgment is hereby GRANTED.
IT IS SO ORDERED.

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Initials of Preparer

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 Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 1 of 33
(MANx),APPEAL,CLOSED,DISCOVERY,MANADR,PROTORD,RELATED−G
UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA (Western Division − Los Angeles)
CIVIL DOCKET FOR CASE #: 2:10−cv−04182−CAS−MAN

Sierra Medical Services Alliance et al v. David Maxwell−Jolly et Date Filed: 06/04/2010

al

Date Terminated: 08/11/2014

Assigned to: Judge Christina A. Snyder

Jury Demand: Plaintiff

Referred to: Magistrate Judge Margaret A. Nagle

Nature of Suit: 950 Constitutional − State

Related Case: 2:08−cv−03315−CAS−MAN

Statute

Case in other court: 9th CCA, 14−56483

Jurisdiction: Federal Question

Cause: 28:2201 Constitutionality of State Statute(s)

Plaintiff

Sierra Medical Services Alliance

represented by Damaris Lynnette Medina Buchalter, A Professional Corporation 1000 Wilshire Blvd., Suite 1500 Los Angeles, CA 90017−1730 213−891−0700 Fax: 213−896−0400 Email: dmedina@buchalter.com LEAD ATTORNEY ATTORNEY TO BE NOTICED

Andrew H Selesnick Buchalter, A Professional Corporation 1000 Wilshire Blvd., Suite 1500 Los Angeles, CA 90017−1730 213−891−5700 Fax: 310−564−2671 Email: aselesnick@mrllp.com ATTORNEY TO BE NOTICED

Edward R Ulloa Hawkins Parnell & Thackston LLP 444 South Flower Street Suite 1100 Los Angeles, CA 90071 213−486−8000 Fax: 213−486−8080 Email: eulloa@hplegal.com TERMINATED: 08/08/2011 ATTORNEY TO BE NOTICED

Kelly M Hagemann Michelman and Robinson LLP 15760 Ventura Boulevard 5th Floor Encino, CA 91436 818−783−5530 Fax: 818−783−5507 Email: khagemann@mrllp.com ATTORNEY TO BE NOTICED

Kevin Richard Warren 121 South Hope Street No 7 Los Angeles, CA 90012 310−773−4904 ATTORNEY TO BE NOTICED

Plaintiff Care Flight

represented by Damaris Lynnette Medina (See above for address) LEAD ATTORNEY

Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 2 of 33

ATTORNEY TO BE NOTICED

Andrew H Selesnick (See above for address) ATTORNEY TO BE NOTICED

Edward R Ulloa (See above for address) TERMINATED: 08/08/2011 ATTORNEY TO BE NOTICED

Kelly M Hagemann (See above for address) ATTORNEY TO BE NOTICED

Kevin Richard Warren (See above for address) ATTORNEY TO BE NOTICED

Plaintiff Riggs Ambulance Service, Inc.

represented by Damaris Lynnette Medina (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED

Andrew H Selesnick (See above for address) ATTORNEY TO BE NOTICED

Edward R Ulloa (See above for address) TERMINATED: 08/08/2011 ATTORNEY TO BE NOTICED

Kelly M Hagemann (See above for address) ATTORNEY TO BE NOTICED

Kevin Richard Warren (See above for address) ATTORNEY TO BE NOTICED

Plaintiff Schaefer Ambulance Service, Inc.

represented by Damaris Lynnette Medina (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED

Andrew H Selesnick (See above for address) ATTORNEY TO BE NOTICED

Edward R Ulloa (See above for address) TERMINATED: 08/08/2011 ATTORNEY TO BE NOTICED

Kelly M Hagemann (See above for address) ATTORNEY TO BE NOTICED

Kevin Richard Warren (See above for address) ATTORNEY TO BE NOTICED

Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 3 of 33

Plaintiff American Ambulance of Visalia
Plaintiff Desert Ambulance Service
Plaintiff San Luis Ambulance Service, Inc.

represented by Damaris Lynnette Medina (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Andrew H Selesnick (See above for address) ATTORNEY TO BE NOTICED
Edward R Ulloa (See above for address) TERMINATED: 08/08/2011 ATTORNEY TO BE NOTICED
Kelly M Hagemann (See above for address) ATTORNEY TO BE NOTICED
Kevin Richard Warren (See above for address) ATTORNEY TO BE NOTICED
represented by Damaris Lynnette Medina (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Andrew H Selesnick (See above for address) ATTORNEY TO BE NOTICED
Edward R Ulloa (See above for address) TERMINATED: 08/08/2011 ATTORNEY TO BE NOTICED
Kelly M Hagemann (See above for address) ATTORNEY TO BE NOTICED
Kevin Richard Warren (See above for address) ATTORNEY TO BE NOTICED
represented by Damaris Lynnette Medina (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Andrew H Selesnick (See above for address) ATTORNEY TO BE NOTICED
Edward R Ulloa (See above for address) TERMINATED: 08/08/2011 ATTORNEY TO BE NOTICED
Kelly M Hagemann

Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 4 of 33

(See above for address) ATTORNEY TO BE NOTICED

Kevin Richard Warren (See above for address) ATTORNEY TO BE NOTICED

Plaintiff
First Responder Emergency Medical Services−Sacramento, Inc.

represented by Damaris Lynnette Medina (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED

Andrew H Selesnick (See above for address) ATTORNEY TO BE NOTICED

Edward R Ulloa (See above for address) TERMINATED: 08/08/2011 ATTORNEY TO BE NOTICED

Kelly M Hagemann (See above for address) ATTORNEY TO BE NOTICED

Kevin Richard Warren (See above for address) ATTORNEY TO BE NOTICED

Plaintiff
First Responder Emergency Medical Services, Inc.

represented by Damaris Lynnette Medina (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED

Andrew H Selesnick (See above for address) ATTORNEY TO BE NOTICED

Edward R Ulloa (See above for address) TERMINATED: 08/08/2011 ATTORNEY TO BE NOTICED

Kelly M Hagemann (See above for address) ATTORNEY TO BE NOTICED

Kevin Richard Warren (See above for address) ATTORNEY TO BE NOTICED

Plaintiff Imperial Ambulance Services, Inc.

represented by Damaris Lynnette Medina (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED

Andrew H Selesnick (See above for address) ATTORNEY TO BE NOTICED

Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 5 of 33

Edward R Ulloa (See above for address) TERMINATED: 08/08/2011 ATTORNEY TO BE NOTICED

Kelly M Hagemann (See above for address) ATTORNEY TO BE NOTICED

Kevin Richard Warren (See above for address) ATTORNEY TO BE NOTICED

Plaintiff Exeter District Ambulance

represented by Damaris Lynnette Medina (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED

Andrew H Selesnick (See above for address) ATTORNEY TO BE NOTICED

Edward R Ulloa (See above for address) TERMINATED: 08/08/2011 ATTORNEY TO BE NOTICED

Kelly M Hagemann (See above for address) ATTORNEY TO BE NOTICED

Kevin Richard Warren (See above for address) ATTORNEY TO BE NOTICED

Plaintiff
Sierra Lifestar, Inc. doing business as Lifestar Ambulance

represented by Damaris Lynnette Medina (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED

Andrew H Selesnick (See above for address) ATTORNEY TO BE NOTICED

Edward R Ulloa (See above for address) TERMINATED: 08/08/2011 ATTORNEY TO BE NOTICED

Kelly M Hagemann (See above for address) ATTORNEY TO BE NOTICED

Kevin Richard Warren (See above for address) ATTORNEY TO BE NOTICED

Plaintiff Del Norte Ambulance, Inc.

represented by Damaris Lynnette Medina (See above for address) LEAD ATTORNEY

Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 6 of 33

ATTORNEY TO BE NOTICED

Andrew H Selesnick (See above for address) ATTORNEY TO BE NOTICED

Edward R Ulloa (See above for address) TERMINATED: 08/08/2011 ATTORNEY TO BE NOTICED

Kelly M Hagemann (See above for address) ATTORNEY TO BE NOTICED

Kevin Richard Warren (See above for address) ATTORNEY TO BE NOTICED

Plaintiff Piner's Ambulance, Inc.

represented by Damaris Lynnette Medina (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED

Andrew H Selesnick (See above for address) ATTORNEY TO BE NOTICED

Edward R Ulloa (See above for address) TERMINATED: 08/08/2011 ATTORNEY TO BE NOTICED

Kelly M Hagemann (See above for address) ATTORNEY TO BE NOTICED

Kevin Richard Warren (See above for address) ATTORNEY TO BE NOTICED

Plaintiff
American Legion Post 108 Ambulance Service

represented by Damaris Lynnette Medina (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED

Andrew H Selesnick (See above for address) ATTORNEY TO BE NOTICED

Edward R Ulloa (See above for address) TERMINATED: 08/08/2011 ATTORNEY TO BE NOTICED

Kelly M Hagemann (See above for address) ATTORNEY TO BE NOTICED

Kevin Richard Warren (See above for address) ATTORNEY TO BE NOTICED

Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 7 of 33

Plaintiff Progressive Ambulance, Inc. doing business as Liberty Ambulance
Plaintiff Hall Ambulance Service, Inc.
Plaintiff City Ambulance of Eureka, Inc.

represented by Damaris Lynnette Medina (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Andrew H Selesnick (See above for address) ATTORNEY TO BE NOTICED
Edward R Ulloa (See above for address) TERMINATED: 08/08/2011 ATTORNEY TO BE NOTICED
Kelly M Hagemann (See above for address) ATTORNEY TO BE NOTICED
Kevin Richard Warren (See above for address) ATTORNEY TO BE NOTICED
represented by Damaris Lynnette Medina (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Andrew H Selesnick (See above for address) ATTORNEY TO BE NOTICED
Edward R Ulloa (See above for address) TERMINATED: 08/08/2011 ATTORNEY TO BE NOTICED
Kelly M Hagemann (See above for address) ATTORNEY TO BE NOTICED
Kevin Richard Warren (See above for address) ATTORNEY TO BE NOTICED
represented by Damaris Lynnette Medina (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Andrew H Selesnick (See above for address) ATTORNEY TO BE NOTICED
Edward R Ulloa (See above for address) TERMINATED: 08/08/2011 ATTORNEY TO BE NOTICED
Kelly M Hagemann

Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 8 of 33

(See above for address) ATTORNEY TO BE NOTICED

Kevin Richard Warren (See above for address) ATTORNEY TO BE NOTICED

Plaintiff Patterson District Ambulance

represented by Damaris Lynnette Medina (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED

Andrew H Selesnick (See above for address) ATTORNEY TO BE NOTICED

Edward R Ulloa (See above for address) TERMINATED: 08/08/2011 ATTORNEY TO BE NOTICED

Kelly M Hagemann (See above for address) ATTORNEY TO BE NOTICED

Kevin Richard Warren (See above for address) ATTORNEY TO BE NOTICED

Plaintiff
K.W.P.H. Enterprises doing business as American Ambulance

represented by Damaris Lynnette Medina (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED

Andrew H Selesnick (See above for address) ATTORNEY TO BE NOTICED

Edward R Ulloa (See above for address) TERMINATED: 08/08/2011 ATTORNEY TO BE NOTICED

Kelly M Hagemann (See above for address) ATTORNEY TO BE NOTICED

Kevin Richard Warren (See above for address) ATTORNEY TO BE NOTICED

Plaintiff Community Ambulance Services, Inc.

represented by Damaris Lynnette Medina (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED

Andrew H Selesnick (See above for address) ATTORNEY TO BE NOTICED

Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 9 of 33

Edward R Ulloa (See above for address) TERMINATED: 08/08/2011 ATTORNEY TO BE NOTICED

Kelly M Hagemann (See above for address) ATTORNEY TO BE NOTICED

Kevin Richard Warren (See above for address) ATTORNEY TO BE NOTICED

Plaintiff Sierra Ambulance Service, Inc.

represented by Damaris Lynnette Medina (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED

Andrew H Selesnick (See above for address) ATTORNEY TO BE NOTICED

Edward R Ulloa (See above for address) TERMINATED: 08/08/2011 ATTORNEY TO BE NOTICED

Kelly M Hagemann (See above for address) ATTORNEY TO BE NOTICED

Kevin Richard Warren (See above for address) ATTORNEY TO BE NOTICED

Plaintiff Care Ambulance Service, Inc.

represented by Damaris Lynnette Medina (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED

Andrew H Selesnick (See above for address) ATTORNEY TO BE NOTICED

Edward R Ulloa (See above for address) TERMINATED: 08/08/2011 ATTORNEY TO BE NOTICED

Kelly M Hagemann (See above for address) ATTORNEY TO BE NOTICED

Kevin Richard Warren (See above for address) ATTORNEY TO BE NOTICED

Plaintiff Delano Ambulance Service, Inc.

represented by Damaris Lynnette Medina (See above for address) LEAD ATTORNEY

Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 10 of 33

ATTORNEY TO BE NOTICED

Andrew H Selesnick (See above for address) ATTORNEY TO BE NOTICED

Edward R Ulloa (See above for address) TERMINATED: 08/08/2011 ATTORNEY TO BE NOTICED

Kelly M Hagemann (See above for address) ATTORNEY TO BE NOTICED

Kevin Richard Warren (See above for address) ATTORNEY TO BE NOTICED

Plaintiff
Kern Emergency Medical Transportation Corporation doing business as Kern Ambulance

represented by Damaris Lynnette Medina (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED

Andrew H Selesnick (See above for address) ATTORNEY TO BE NOTICED

Edward R Ulloa (See above for address) TERMINATED: 08/08/2011 ATTORNEY TO BE NOTICED

Kelly M Hagemann (See above for address) ATTORNEY TO BE NOTICED

Kevin Richard Warren (See above for address) ATTORNEY TO BE NOTICED

Plaintiff
Manteca District Volunteer Ambulance Service doing business as Manteca District Ambulance Service

represented by Damaris Lynnette Medina (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED

Andrew H Selesnick (See above for address) ATTORNEY TO BE NOTICED

Edward R Ulloa (See above for address) TERMINATED: 08/08/2011 ATTORNEY TO BE NOTICED

Kelly M Hagemann (See above for address) ATTORNEY TO BE NOTICED

Kevin Richard Warren (See above for address) ATTORNEY TO BE NOTICED

Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 11 of 33

Plaintiff Westmed Ambulance, Inc.
Plaintiff California Ambulance Association
Plaintiff Regional Emergency Medical Services Authority
Plaintiff Metro West Ambulance Service, Inc.

represented by Damaris Lynnette Medina (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Andrew H Selesnick (See above for address) ATTORNEY TO BE NOTICED
Kelly M Hagemann (See above for address) ATTORNEY TO BE NOTICED
Kevin Richard Warren (See above for address) ATTORNEY TO BE NOTICED
represented by Damaris Lynnette Medina (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Andrew H Selesnick (See above for address) ATTORNEY TO BE NOTICED
Kelly M Hagemann (See above for address) ATTORNEY TO BE NOTICED
Kevin Richard Warren (See above for address) ATTORNEY TO BE NOTICED
represented by Damaris Lynnette Medina (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Andrew H Selesnick (See above for address) ATTORNEY TO BE NOTICED
Kelly M Hagemann (See above for address) ATTORNEY TO BE NOTICED
Kevin Richard Warren (See above for address) ATTORNEY TO BE NOTICED
represented by Damaris Lynnette Medina (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Andrew H Selesnick (See above for address)

Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 12 of 33
ATTORNEY TO BE NOTICED
Kelly M Hagemann (See above for address) ATTORNEY TO BE NOTICED
Kevin Richard Warren (See above for address) ATTORNEY TO BE NOTICED

V.
Defendant
David Maxwell−Jolly former Director of the Department of Health Care Services of the State of California

represented by Hadara Rachel Stanton CAAG − Office of the Attorney General California Department of Justice 455 Golden Gate Avenue Suite 11000 San Francisco, CA 94102 415−703−5561 Fax: 415−703−5480 Email: hadara.stanton@doj.ca.gov ATTORNEY TO BE NOTICED
Jennifer M Kim CAAG − Office of CA Attorney General California Department of Justice 300 South Spring Street Suite 1702 Los Angeles, CA 90012 213−897−2443 Fax: 213−897−2805 Email: jennifer.kim@doj.ca.gov TERMINATED: 04/02/2013 ATTORNEY TO BE NOTICED
Nimrod P Elias CAAG − Office of the Attorney General 455 Golden Gate Avenue Suite 11000 San Francisco, CA 94102 415−703−5841 Fax: 415−7035480 Email: Nimrod.Elias@doj.ca.gov TERMINATED: 04/02/2013 ATTORNEY TO BE NOTICED
Chara L Crane CAAG − Office of the Attorney General California Department of Justice 300 South Spring Street Suite 1702 Los Angeles, CA 90013 213−897−2458 Fax: 213−897−2805 Email: chara.crane@doj.ca.gov TERMINATED: 04/02/2013 ATTORNEY TO BE NOTICED
Leslie P McElroy CAAG − Office of Attorney General California Department of Justice 300 South Spring Street Suite 9 N Los Angeles, CA 90013−1230 213−897−2000 Email: Leslie.McElroy@doj.ca.gov TERMINATED: 04/02/2013

Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 13 of 33

ATTORNEY TO BE NOTICED

Richard T Waldow CAAG − Office of Attorney General California Department of Justice 300 South Spring Street Suite 1702 Los Angeles, CA 90013−1230 213−897−2456 Fax: 213−897−2805 Email: richard.waldow@doj.ca.gov TERMINATED: 04/02/2013 ATTORNEY TO BE NOTICED

Tara L Newman CAAG − Office of the Attorney General California Department of Justice 300 South Spring Street Suite 1702 Los Angeles, CA 90013−1230 213−269−6216 Fax: 213−897−2805 Email: tara.newman@doj.ca.gov TERMINATED: 04/02/2013 ATTORNEY TO BE NOTICED

Tracey L Angelopoulos CAAG − Office of the Attorney General California Department of Justice 110 West A Street, Suite 1100 San Diego, CA 92101 619−645−2067 Fax: 619−645−2067 TERMINATED: 04/02/2013 ATTORNEY TO BE NOTICED

Defendant
California Department of Health Care Services TERMINATED: 09/20/2012

represented by Hadara Rachel Stanton (See above for address) ATTORNEY TO BE NOTICED

Jennifer M Kim (See above for address) TERMINATED: 04/02/2013 ATTORNEY TO BE NOTICED

Nimrod P Elias (See above for address) TERMINATED: 04/02/2013 ATTORNEY TO BE NOTICED

Chara L Crane (See above for address) TERMINATED: 04/02/2013 ATTORNEY TO BE NOTICED

Leslie P McElroy (See above for address) TERMINATED: 04/02/2013 ATTORNEY TO BE NOTICED

Richard T Waldow (See above for address) TERMINATED: 04/02/2013 ATTORNEY TO BE NOTICED

Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 14 of 33

Tara L Newman (See above for address) TERMINATED: 04/02/2013 ATTORNEY TO BE NOTICED

Tracey L Angelopoulos (See above for address) TERMINATED: 04/02/2013 ATTORNEY TO BE NOTICED

Defendant
Toby Douglas Director of the Department of Health Care Services of th State of California

represented by Hadara Rachel Stanton (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED

Date Filed 06/04/2010
06/04/2010 06/04/2010
06/04/2010 06/09/2010 06/24/2010 07/01/2010

# Docket Text
1 COMPLAINT against Defendants California Department of Health Care Services, David Maxwell−Jolly. Case assigned to Judge Ronald S.W. Lew for all further proceedings. Discovery referred to Magistrate Judge Charles F. Eick. (Filing fee $ 350 PAID.) Jury Demanded., filed by Plaintiffs American Ambulance of Visalia, American Legion Post 108 Ambulance Service, Care Ambulance Service, Inc., Care Flight, City Ambulance of Eureka, Inc., Community Ambulance Services, Inc., Del Norte Ambulance, Inc., Delano Ambulance Service, Inc., Desert Ambulance Service, Exeter District Ambulance, First Responder Emergency Medical Services, Inc., First Responder Emergency Medical Services−Sacramento, Inc., Hall Ambulance Service, Inc., Imperial Ambulance Services, Inc., K.W.P.H. Enterprises, Kern Emergency Medical Transportation Corporation, Manteca District Volunteer Ambulance Service, Patterson District Ambulance, Piner's Ambulance, Inc., Progressive Ambulance, Inc., Riggs Ambulance Service, Inc., San Luis Ambulance Service, Inc., Schaefer Ambulance Service, Inc., Sierra Ambulance Service, Inc., Sierra Lifestar, Inc., Sierra Medical Services Alliance. (et) (mg). (Entered: 06/07/2010)
21 DAY Summons Issued re Complaint − (Discovery) 1 as to Defendants California Department of Health Care Services, David Maxwell−Jolly. (et) (Entered: 06/07/2010)
2 CERTIFICATION AND NOTICE of Interested Parties filed by Plaintiffs American Ambulance of Visalia, American Legion Post 108 Ambulance Service, Care Ambulance Service, Inc., Care Flight, City Ambulance of Eureka, Inc., Community Ambulance Services, Inc., Del Norte Ambulance, Inc., Delano Ambulance Service, Inc., Desert Ambulance Service, Exeter District Ambulance, First Responder Emergency Medical Services, Inc., First Responder Emergency Medical Services−Sacramento, Inc., Hall Ambulance Service, Inc., Imperial Ambulance Services, Inc., K.W.P.H. Enterprises, Kern Emergency Medical Transportation Corporation, Manteca District Volunteer Ambulance Service, Patterson District Ambulance, Piner's Ambulance, Inc., Progressive Ambulance, Inc., Riggs Ambulance Service, Inc., San Luis Ambulance Service, Inc., Schaefer Ambulance Service, Inc., Sierra Ambulance Service, Inc., Sierra Lifestar, Inc., Sierra Medical Services Alliance. (et) (mg). (Entered: 06/07/2010)
3 NOTICE TO PARTIES OF ADR PROGRAM filed. (et) (Entered: 06/07/2010)
4 ORDER RETURNING CASE FOR REASSIGNMENT by Judge Ronald S.W. Lew. ORDER case returned to the Clerk for random reassignment pursuant to General Order 08−05. Case randomly reassigned from Judge Ronald S.W. Lew to Judge S. James Otero for all further proceedings. The case number will now reflect the initials of the transferee Judge CV 10−4182 SJO(Ex). (rn) (Entered: 06/09/2010)
5 INITIAL STANDING ORDER FOR CASES ASSIGNED TO JUDGE S. JAMES OTERO by Judge S. James Otero, (lc) (Entered: 06/24/2010)
6 NOTICE of Related Case(s) filed by Defendant California Department of Health Care Services, David Maxwell−Jolly. Related Case(s): CV 09−7097 CAS (FFMx) and CV 09−8200 CAS (MANx) (Kim, Jennifer) (Entered: 07/01/2010)

Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 15 of 33

07/01/2010 07/01/2010 07/01/2010 07/01/2010 07/01/2010 07/01/2010 07/06/2010

7 NOTICE of Change of Attorney Information for attorney Jennifer M Kim counsel for Defendants California Department of Health Care Services, David Maxwell−Jolly. Adding Tara L. Newman as attorney as counsel of record for DAVID MAXWELL−JOLLY, Director of the Department of Health Care Services of the State of California, CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES for the reason indicated in the G−06 Notice. Filed by Defendant DAVID MAXWELL−JOLLY, Director of the Department of Health Care Services of the State of California, CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES (Kim, Jennifer) (Entered: 07/01/2010)
8 NOTICE of Change of Attorney Information for attorney Jennifer M Kim counsel for Defendants California Department of Health Care Services, David Maxwell−Jolly. Adding TRACEY L. ANGELOPOULOS as attorney as counsel of record for DAVID MAXWELL−JOLLY, Director of the Department of Health Care Services of the State of California, CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES for the reason indicated in the G−06 Notice. Filed by DEFENDANT DAVID MAXWELL−JOLLY, Director of the Department of Health Care Services of the State of California, CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES (Kim, Jennifer) (Entered: 07/01/2010)
9 NOTICE of Change of Attorney Information for attorney Jennifer M Kim counsel for Defendants California Department of Health Care Services, David Maxwell−Jolly. Adding RICHARD T. WALDOW as attorney as counsel of record for DAVID MAXWELL−JOLLY, Director of the Department of Health Care Services of the State of California, CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES for the reason indicated in the G−06 Notice. Filed by DEFENDANT DAVID MAXWELL−JOLLY, Director of the Department of Health Care Services of the State of California, CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES (Kim, Jennifer) (Entered: 07/01/2010)
10 NOTICE of Change of Attorney Information for attorney Jennifer M Kim counsel for Defendants California Department of Health Care Services, David Maxwell−Jolly. Adding LESLIE P. McELROY as attorney as counsel of record for DAVID MAXWELL−JOLLY, Director of the Department of Health Care Services of the State of California, CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES for the reason indicated in the G−06 Notice. Filed by DEFENDANT DAVID MAXWELL−JOLLY, Director of the Department of Health Care Services of the State of California, CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES (Kim, Jennifer) (Entered: 07/01/2010)
11 NOTICE of Change of Attorney Information for attorney Jennifer M Kim counsel for Defendants California Department of Health Care Services, David Maxwell−Jolly. Adding JENNIFER M. KIM as attorney as counsel of record for DAVID MAXWELL−JOLLY, Director of the Department of Health Care Services of the State of California, CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES for the reason indicated in the G−06 Notice. Filed by DEFENDANT DAVID MAXWELL−JOLLY, Director of the Department of Health Care Services of the State of California, CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES (Kim, Jennifer) (Entered: 07/01/2010)
12 NOTICE of Change of Attorney Information for attorney Jennifer M Kim counsel for Defendants California Department of Health Care Services, David Maxwell−Jolly. Adding CHARA L. CRANE as attorney as counsel of record for DAVID MAXWELL−JOLLY, Director of the Department of Health Care Services of the State of California, CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES, for the reason indicated in the G−06 Notice. Filed by DEFENDANT DAVID MAXWELL−JOLLY, Director of the Department of Health Care Services of the State of California, CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES (Kim, Jennifer) (Entered: 07/01/2010)
13 First EX PARTE APPLICATION to Shorten Time for Hearing to July 19, 2010, First EX PARTE APPLICATION to Stay Case pending resolution of Petition for Writ of Cert in US Supreme Court filed by Defendants California Department of Health Care Services, David Maxwell−Jolly. (Attachments: # 1 Memorandum, # 2 Declaration, # 3 Proposed Order)(Crane, Chara) (Entered: 07/06/2010)

Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 16 of 33

07/06/2010 07/07/2010 07/07/2010
07/07/2010
07/07/2010 07/07/2010

14 NOTICE OF MOTION AND First MOTION to Stay Case pending resolution of Petition for Writ of Certiorari in US Supreme Court filed by Defendants California Department of Health Care Services, David Maxwell−Jolly. Motion set for hearing on 7/19/2010 at 10:00 AM before Judge S. James Otero. (Attachments: # 1 Memorandum, # 2 Declaration, # 3 Proposed Order)(Crane, Chara) (Entered: 07/06/2010)
15 ORDER by Judge S. James Otero: the following document(s) be STRICKEN for failure to comply with the Local Rules, General Order and/or the Courts Case Management Order: First MOTION to Stay Case pending resolution of Petition for Writ of Certiorari in US Supreme Court 14 , for the following reasons: Hearing information is missing, incorrect, or not timely;Does not comply with Local Rule 6−1 Notice and Service of Motion. Unless otherwise provided by rule or order of the Court, no oral motions will be recognized and every motion shall be presented by written notice of motion. The notice of motion shall be filed with the Clerk not later than twenty−eight (28) days before the date set for hearing. (lc) (Entered: 07/07/2010)
16 PROOF OF SERVICE Executed by Plaintiff American Ambulance of Visalia, American Legion Post 108 Ambulance Service, California Department of Health Care Services, Care Ambulance Service, Inc., Care Flight, City Ambulance of Eureka, Inc., Community Ambulance Services, Inc., Del Norte Ambulance, Inc., Delano Ambulance Service, Inc., Desert Ambulance Service, Exeter District Ambulance, First Responder Emergency Medical Services, Inc., First Responder Emergency Medical Services−Sacramento, Inc., Hall Ambulance Service, Inc., Imperial Ambulance Services, Inc., K.W.P.H. Enterprises, Kern Emergency Medical Transportation Corporation, Manteca District Volunteer Ambulance Service, David Maxwell−Jolly, Patterson District Ambulance, Piner's Ambulance, Inc., Progressive Ambulance, Inc., Riggs Ambulance Service, Inc., San Luis Ambulance Service, Inc., Schaefer Ambulance Service, Inc., Sierra Ambulance Service, Inc., Sierra Lifestar, Inc., Sierra Medical Services Alliance, upon Defendant David Maxwell−Jolly served on 6/9/2010, answer due 6/30/2010. Service of the Summons and Complaint were executed upon Director of the Dept. of Health Care Services, State of California in compliance with Federal Rules of Civil Procedure by service on a domestic corporation, unincorporated association, or public entity. Original Summons returned. (Warren, Kevin) (Entered: 07/07/2010)
17 PROOF OF SERVICE Executed by Plaintiff American Ambulance of Visalia, American Legion Post 108 Ambulance Service, California Department of Health Care Services, Care Ambulance Service, Inc., Care Flight, City Ambulance of Eureka, Inc., Community Ambulance Services, Inc., Del Norte Ambulance, Inc., Delano Ambulance Service, Inc., Desert Ambulance Service, Exeter District Ambulance, First Responder Emergency Medical Services, Inc., First Responder Emergency Medical Services−Sacramento, Inc., Hall Ambulance Service, Inc., Imperial Ambulance Services, Inc., K.W.P.H. Enterprises, Kern Emergency Medical Transportation Corporation, Manteca District Volunteer Ambulance Service, David Maxwell−Jolly, Patterson District Ambulance, Piner's Ambulance, Inc., Progressive Ambulance, Inc., Riggs Ambulance Service, Inc., San Luis Ambulance Service, Inc., Schaefer Ambulance Service, Inc., Sierra Ambulance Service, Inc., Sierra Lifestar, Inc., Sierra Medical Services Alliance, upon Defendant California Department of Health Care Services served on 6/9/2010, answer due 6/30/2010. Service of the Summons and Complaint were executed upon Janet Alexander, Staff Counsel in compliance with Federal Rules of Civil Procedure by service on a domestic corporation, unincorporated association, or public entity. Original Summons returned. (Warren, Kevin) (Entered: 07/07/2010)
18 ORDER RE TRANSFER PURSUANT TO GENERAL ORDER 08−05 −Related Case− filed. Related Case No: CV 08−03315 CAS(MANx). Case transferred from Magistrate Judge Charles F. Eick and Judge S. James Otero to Judge Christina A. Snyder and Magistrate Judge Margaret A. Nagle for all further proceedings. The case number will now reflect the initials of the transferee Judge CV 10−04182 CAS(MANx).Signed by Judge Christina A. Snyder (rn) (Entered: 07/07/2010)
19 NOTICE OF MOTION AND MOTION to Stay Case pending Resolution of the Director's Petitions for Certiorari in the US Supreme Court filed by Defendant California Department of Health Care Services. Motion set for hearing on 8/9/2010 at 10:00 AM before Judge S. James Otero. (Attachments: # 1 Proposed Order, # 2 Memorandum of Points and authorities in Support of Motion for Stay, # 3 Declaration

Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 17 of 33

07/07/2010
07/13/2010 07/16/2010 07/16/2010 07/19/2010
07/21/2010

of Deputy Attorney General Tracey L. Angelopoulos in Support of Motionfor Stay)(Angelopoulos, Tracey) (Entered: 07/07/2010)
20 Opposition re: First EX PARTE APPLICATION to Shorten Time for Hearing to July 19, 2010First EX PARTE APPLICATION to Stay Case pending resolution of Petition for Writ of Cert in US Supreme Court 13 Opposition filed by Plaintiffs American Ambulance of Visalia, American Legion Post 108 Ambulance Service, Care Ambulance Service, Inc., Care Flight, City Ambulance of Eureka, Inc., Community Ambulance Services, Inc., Del Norte Ambulance, Inc., Delano Ambulance Service, Inc., Desert Ambulance Service, Exeter District Ambulance, First Responder Emergency Medical Services, Inc., First Responder Emergency Medical Services−Sacramento, Inc., Hall Ambulance Service, Inc., Imperial Ambulance Services, Inc., K.W.P.H. Enterprises, Kern Emergency Medical Transportation Corporation, Manteca District Volunteer Ambulance Service, Patterson District Ambulance, Piner's Ambulance, Inc., Progressive Ambulance, Inc., Riggs Ambulance Service, Inc., San Luis Ambulance Service, Inc., Schaefer Ambulance Service, Inc., Sierra Ambulance Service, Inc., Sierra Lifestar, Inc., Sierra Medical Services Alliance. (Attachments: # 1 Declaration)(Warren, Kevin) (Entered: 07/07/2010)
21 First STIPULATION for Extension of Time to File RESPONSE TO COMPLAINT filed by Defendants California Department of Health Care Services, David Maxwell−Jolly. (Attachments: # 1 Declaration)(Crane, Chara) (Entered: 07/13/2010)
22 NOTICE TO FILER OF DEFICIENCIES in Electronically Filed Documents RE: Stipulation to Extend Time to Respond to Initial Complaint By Not More Than 30 Days filed 7/13/2010 21 . The following error(s) was found: Incorrect event selected. The correct event is: Stipulations − Extending Time to Answer (30 days or less). Stipulations − Extension of Time to File Document event utilized in docketing this filing. Clerk has updated defendant's answer due date to 7/30/2010. In response to this notice the court may order (1) an amended or correct document to be filed (2) the document stricken or (3) take other action as the court deems appropriate. You need not take any action in response to this notice unless and until the court directs you to do so. (gk) (Entered: 07/16/2010)
23 MINUTES (IN CHAMBERS) by Judge Christina A. Snyder: The Court GRANTS Defendants' Ex Parte Application for a Stay, or Alternatively, for an Order Shortening Time on Defendants' Motion to Stay 13 . Within 30 days from the date of this order, or upon the disposition of the petitions for certiorari, whichever occurs first, the parties shall file a joint status report. Because defendants' Motion to Stay, filed 7/6/2010 19 , seeks the same relief granted herein the Motion to Stay is hereby DENIED as moot. Court Reporter: Not Present. (gk) (Entered: 07/19/2010)
24 MEMORANDUM in Opposition to MOTION to Stay Case pending Resolution of the Director's Petitions for Certiorari in the US Supreme Court 19 filed by Plaintiffs American Ambulance of Visalia, American Legion Post 108 Ambulance Service, Care Ambulance Service, Inc., Care Flight, City Ambulance of Eureka, Inc., Community Ambulance Services, Inc., Del Norte Ambulance, Inc., Delano Ambulance Service, Inc., Desert Ambulance Service, Exeter District Ambulance, First Responder Emergency Medical Services, Inc., First Responder Emergency Medical Services−Sacramento, Inc., Hall Ambulance Service, Inc., Imperial Ambulance Services, Inc., K.W.P.H. Enterprises, Kern Emergency Medical Transportation Corporation, Manteca District Volunteer Ambulance Service, Patterson District Ambulance, Piner's Ambulance, Inc., Progressive Ambulance, Inc., Riggs Ambulance Service, Inc., San Luis Ambulance Service, Inc., Schaefer Ambulance Service, Inc., Sierra Ambulance Service, Inc., Sierra Lifestar, Inc., Sierra Medical Services Alliance. (Attachments: # 1 Declaration)(Warren, Kevin) (Entered: 07/19/2010)
25 NOTICE TO FILER OF DEFICIENCIES in Electronically Filed Documents RE: Plaintiffs' Opposition to Defendants' Motion for Stay 24 . The following error(s) was found: Local Rule 11−8 Memorandum brief exceeding 10 pages shall contain table of contents. In response to this notice the court may order (1) an amended or correct document to be filed (2) the document stricken or (3) take other action as the court deems appropriate. You need not take any action in response to this notice unless and until the court directs you to do so. (jp) (Entered: 07/22/2010)

Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 18 of 33

07/26/2010
08/16/2010 08/16/2010 08/18/2010
10/04/2010 02/11/2011 06/01/2011
07/08/2011 07/08/2011 07/08/2011
07/13/2011
07/13/2011

26 NOTICE TO COUNSEL by Judge Christina A. Snyder. This Notice to Counsel shall be to all parties appearing in propria persona, and for purposes of this notice, the term "counsel" shall include any person appearing in pro per. Counsel are advised that the Court expects strict compliance with the provisions of the Local Rules and the Federal Rules of Civil Procedure. The attention of counsel is particularly directed to Local Rules 16 and 26 for the conduct of mandatory pretrial and settlement proceedings. (Refer to attached document for other requirements.) (lom) (Entered: 07/28/2010)
27 STATUS REPORT filed by Defendants California Department of Health Care Services, David Maxwell−Jolly. (Angelopoulos, Tracey) (Entered: 08/16/2010)
28 STATUS REPORT Pursuant to the Court's July 16, 2010 Order filed by Plaintiff Sierra Medical Services Alliance. (Warren, Kevin) (Entered: 08/16/2010)
29 MINUTES OF TELEPHONIC STATUS CONFERENCE held before Judge Christina A. Snyder. Court continues stay until October 15, 2010. The parties shall file a joint status report no later than October 7, 2010, or upon the disposition of the petitions for certiorari, whichever occurs first. Counsel are instructed to contact the court clerk if disposition is prior to the scheduled dates.Court Reporter: LAURA ELIAS. (pp) (Entered: 08/30/2010)
30 STATUS REPORT filed by Defendants California Department of Health Care Services, David Maxwell−Jolly. (Angelopoulos, Tracey) (Entered: 10/04/2010)
31 NOTICE OF GRANTING CERTIORARI filed by Defendant California Department of Health Care Services. (Attachments: # 1 Exhibit A)(Angelopoulos, Tracey) (Entered: 02/11/2011)
32 MINUTE ORDER IN CHAMBERS by Judge Christina A. Snyder: Counsel shall continue to file quarterly status reports detailing the status of the case until the action has been reactivated on this Courts active caseload or a stipulation for dismissal is filed. This Court retains full jurisdiction over this action and this Order shall not prejudice any party to this action. SEE ORDER. (Made JS−6. Case Terminated.) (im) (Entered: 06/02/2011)
33 Summons Returned Unexecuted filed by Plaintiffs Sierra Ambulance Service, Inc.. as to All Defendants. (Attachments: # 1 Supplement Certification and Notice of Interested Parties)(Warren, Kevin) (Entered: 07/08/2011)
34 Summons Returned Unexecuted filed by Plaintiffs Sierra Ambulance Service, Inc.. as to All Defendants. (Attachments: # 1 Supplement Certification and Notice of Interested Parties)(Warren, Kevin) (Entered: 07/08/2011)
35 PROOF OF SERVICE Executed by Plaintiff Sierra Medical Services Alliance, upon Defendant California Department of Health Care Services served on 7/8/2010, answer due 7/29/2010. Service of the Summons and Complaint were executed upon Toby Douglas, Director of the Department of Health Care Services of the State of CA in compliance with Federal Rules of Civil Procedure by personal service. Original Summons NOT returned. (Attachments: # 1 Supplement Proof of Service)(Warren, Kevin) (Entered: 07/08/2011)
36 NOTICE TO FILER OF DEFICIENCIES in Electronically Filed Documents RE: 21−Day Summons and First Amended Complaint filed 7/8/2011 33 . The following error(s) was found: Case is closed. Case removed from active list on 6/1/2011. No order on docket allowing the filing of a First Amended Complaint. Pursuant to General Order 10−07 and Local Rule 3−2, initiating documents (including amended complaints) should be manually submitted. In response to this notice the court may order (1) an amended or correct document to be filed (2) the document stricken or (3) take other action as the court deems appropriate. You need not take any action in response to this notice unless and until the court directs you to do so. (gk) (Entered: 07/13/2011)
37 NOTICE TO FILER OF DEFICIENCIES in Electronically Filed Documents RE: 14−Day Summons and First Amended Complaint filed 7/8/2011 34 . The following error(s) was found: Case is closed. Case removed from active list on 6/1/2011. No order on docket allowing the filing of a First Amended Complaint. Pursuant to General Order 10−07 and Local Rule 3−2, initiating documents (including amended complaints) should be manually submitted. In response to this notice the court may

Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 19 of 33

07/14/2011 07/14/2011 07/14/2011 07/14/2011 07/15/2011
07/15/2011
07/19/2011 07/26/2011 08/01/2011

order (1) an amended or correct document to be filed (2) the document stricken or (3) take other action as the court deems appropriate. You need not take any action in response to this notice unless and until the court directs you to do so. (gk) (Entered: 07/13/2011)
38 EXPARTE APPLICATION for Extension of Time to File a responsive Pleading to Plaintiffs Amended Complaint within 21 days of the stay being lifted filed by DEFENDANTS California Department of Health Care Services. (Attachments: # 1 Declaration of Tracey L. Angelopoulos, # 2 Memorandum of Points and Authorities)(Angelopoulos, Tracey) (Entered: 07/14/2011)
39 STATUS REPORT and Request to Lift Stay and Reopen Case; Proposed Order filed by Plaintiff Sierra Medical Services Alliance. (Attachments: # 1 Exhibit Exhibit A, # 2 Exhibit Exhibit B)(Warren, Kevin) (Entered: 07/14/2011)
40 Plaintiffs' Opposition to Defendants' Ex Parte Application for an Order that Defendants May File a Responsive Pleading to Plaintiffs' Amended Complaint Within 21 days of the Stay Being Lifted re: EXPARTE APPLICATION for Extension of Time to File a responsive Pleading to Plaintiffs Amended Complaint within 21 days of the stay being lifted 38 filed by Plaintiff Sierra Medical Services Alliance. (Warren, Kevin) (Entered: 07/14/2011)
41 STATUS REPORT Opposition to Plaintiffs' Status Report and Request to lift stay filed by Defendant California Department of Health Care Services. (Angelopoulos, Tracey) (Entered: 07/14/2011)
42 NOTICE TO FILER OF DEFICIENCIES in Electronically Filed Documents RE: Defendants' Ex Parte Application for an Order Stating that Defendants May File a Responsive Pleading to Plaintiffs Amended Complaint within 21 days of the Stay Being Lifted filed 7/14/2011 38 . The following error(s) was found: Proposed order not submitted pursuant to Local Rule 52−4.1. In response to this notice the court may order (1) an amended or correct document to be filed (2) the document stricken or (3) take other action as the court deems appropriate. You need not take any action in response to this notice unless and until the court directs you to do so. (gk) (Entered: 07/18/2011)
43 NOTICE TO FILER OF DEFICIENCIES in Electronically Filed Documents RE: Plaintiffs' Status Report and Request to Lift Stay and Reopen Case filed 7/14/2011 39 . The following error(s) was found: Local Rule 7−19.1 Notice to other parties of Ex Parte Application lacking. Proposed order not submitted pursuant to Local Rule 52−4.1. In response to this notice the court may order (1) an amended or correct document to be filed (2) the document stricken or (3) take other action as the court deems appropriate. You need not take any action in response to this notice unless and until the court directs you to do so. (gk) (Entered: 07/18/2011)
44 NOTICE OF LODGING filed re Notice of Deficiency in Electronically Filed Documents (G−112), Notice of Deficiency in Electronically Filed Documents (G−112), Notice of Deficiency in Electronically Filed Documents (G−112) 42 , Notice of Deficiency in Electronically Filed Documents (G−112), Notice of Deficiency in Electronically Filed Documents (G−112), Notice of Deficiency in Electronically Filed Documents (G−112) 43 (Attachments: # 1 Proposed Order PROPOSED ORDER)(Newman, Tara) (Entered: 07/19/2011)
45 MINUTES (IN CHAMBERS) by Judge Christina A. Snyder: The Court hereby DENIES Plaintiffs' Status Report and Request to Lift Stay and Reopen the Case 41 without prejudice to being renewed by properly noticed motion. The Court hereby DENIES as moot Defendants' Ex Parte Application for Extension of Time to File a Responsive Pleading to Plaintiffs' Amended Complaint 38 within 21 days of thestay being lifted. Court Reporter: Not Present. (gk) (Entered: 07/27/2011)
46 NOTICE OF LODGING filed of Proposed First Amended Complaint re Notice of Deficiency in Electronically Filed Documents (G−112), Notice of Deficiency in Electronically Filed Documents (G−112), Notice of Deficiency in Electronically Filed Documents (G−112) 43 (Attachments: # 1 Supplement)(Warren, Kevin) (Entered: 08/01/2011)

Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 20 of 33

08/01/2011 08/04/2011 08/08/2011 08/08/2011 08/12/2011
08/15/2011
08/29/2011 08/29/2011

47 NOTICE OF MOTION AND First MOTION to Lift Stay re and Place Case on Court's Active List filed by Plaintiffs Sierra Medical Services Alliance. Motion set for hearing on 8/29/2011 at 10:00 AM before Judge Christina A. Snyder. (Attachments: # 1 Declaration, # 2 Exhibit, # 3 Proposed Order)(Warren, Kevin) (Entered: 08/01/2011)
48 First REQUEST to Substitute attorney Kevin R. Warren in place of attorney Kevin R. Warren filed by Plaintiffs Sierra Medical Services Alliance. (Attachments: # 1 Proposed Order Order on Request for Approval of Substitution of Attorney)(Warren, Kevin) (Entered: 08/04/2011)
49 Opposition to Motion to Lift Stay and Place Case on Court's Active list Opposition re: First MOTION to Lift Stay re and Place Case on Court's Active List 47 filed by Defendant California Department of Health Care Services. (Attachments: # 1 Declaration of Tracey L. Angelopoulos in Support of Opposition to Motion to Lift Stat)(Angelopoulos, Tracey) (Entered: 08/08/2011)
50 ORDER by Judge Christina A. Snyder granting Request for Approval of Substitution of Attorney Kevin R. Warren of Michelman & Robinson, LLP for Plaintiffs Sierra Medical Services Alliances, et al. in place of Kevin R. Warren, Kelly M. Hagemann and Edward R. Ulloa, Hawkins Parnell Thackston & Young LLP 48 . (gk) (Entered: 08/09/2011)
51 NOTICE of Change of Attorney Information for attorney Kevin Richard Warren counsel for Plaintiffs American Ambulance of Visalia, American Legion Post 108 Ambulance Service, Care Ambulance Service, Inc., Care Flight, City Ambulance of Eureka, Inc., Community Ambulance Services, Inc., Del Norte Ambulance, Inc., Delano Ambulance Service, Inc., Desert Ambulance Service, Exeter District Ambulance, First Responder Emergency Medical Services, Inc., First Responder Emergency Medical Services−Sacramento, Inc., Hall Ambulance Service, Inc., Imperial Ambulance Services, Inc., K.W.P.H. Enterprises, Kern Emergency Medical Transportation Corporation, Manteca District Volunteer Ambulance Service, Patterson District Ambulance, Piner's Ambulance, Inc., Progressive Ambulance, Inc., Riggs Ambulance Service, Inc., San Luis Ambulance Service, Inc., Schaefer Ambulance Service, Inc., Sierra Ambulance Service, Inc., Sierra Lifestar, Inc., Sierra Medical Services Alliance. Changing Michelman & Robinson, LLP, 15760 Ventura Blvd., 5th Floor, Encino, CA 91436 to Michelman & Robinson, LLP, 15760 Ventura Blvd., 5th Floor, Encino, CA 91436. Changing kwarren@mrllp.com to 818−783−5507. Filed by attorney for plaintiffs Kevin Warren (Warren, Kevin) (Entered: 08/12/2011)
52 REPLY Plaintiffs' Reply to Defendants Opposition to Motion to Lift Stay and Place Case on Court's Active List First MOTION to Lift Stay re and Place Case on Court's Active List 47 filed by Plaintiffs American Ambulance of Visalia, American Legion Post 108 Ambulance Service, Care Ambulance Service, Inc., Care Flight, City Ambulance of Eureka, Inc., Community Ambulance Services, Inc., Del Norte Ambulance, Inc., Delano Ambulance Service, Inc., Desert Ambulance Service, Exeter District Ambulance, First Responder Emergency Medical Services, Inc., First Responder Emergency Medical Services−Sacramento, Inc., Hall Ambulance Service, Inc., Imperial Ambulance Services, Inc., K.W.P.H. Enterprises, Kern Emergency Medical Transportation Corporation, Manteca District Volunteer Ambulance Service, Patterson District Ambulance, Piner's Ambulance, Inc., Progressive Ambulance, Inc., Riggs Ambulance Service, Inc., San Luis Ambulance Service, Inc., Schaefer Ambulance Service, Inc., Sierra Ambulance Service, Inc., Sierra Lifestar, Inc., Sierra Medical Services Alliance. (Attachments: # 1 Declaration of Kevin R. Warren, # 2 Exhibit A−D to Declaration of Kevin R. Warren)(Warren, Kevin) (Entered: 08/15/2011)
53 MINUTES OF Motion Hearing held before Judge Christina A. Snyder: The Court hears oral argument from counsel and take Plaintiff's Motion to Lift Stay and Place Case on Court's Active List 47 under submission. An order will issue. Court Reporter: Laura Elias. (gk) (Entered: 08/30/2011)
54 MINUTES (IN CHAMBERS) by Judge Christina A. Snyder: The Court hereby DENIES Plaintiffs' Motion to Lift Stay and Place the Case on the Court's Active List 47 . The parties shall continue to file quarterly status reports detailing the status of the case until the action has been reactivated on this Court's active caseload or a stipulation for dismissal is filed. Court Reporter: Laura Elias. (gk) (Entered: 08/30/2011)

Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 21 of 33

02/28/2012 04/24/2012 05/02/2012
08/02/2012
08/02/2012
08/17/2012 08/17/2012

55 NOTICE of Appearance filed by attorney Nimrod P Elias on behalf of Defendants California Department of Health Care Services, David Maxwell−Jolly (Elias, Nimrod) (Entered: 02/28/2012)
56 NOTICE of Appearance filed by attorney Hadara Rachel Stanton on behalf of Defendant California Department of Health Care Services (Stanton, Hadara) (Entered: 04/24/2012)
57 STATUS REPORT (JOINT) filed by Plaintiffs American Ambulance of Visalia, American Legion Post 108 Ambulance Service, Care Ambulance Service, Inc., Care Flight, City Ambulance of Eureka, Inc., Community Ambulance Services, Inc., Del Norte Ambulance, Inc., Delano Ambulance Service, Inc., Desert Ambulance Service, Exeter District Ambulance, First Responder Emergency Medical Services, Inc., First Responder Emergency Medical Services−Sacramento, Inc., Hall Ambulance Service, Inc., Imperial Ambulance Services, Inc., K.W.P.H. Enterprises, Kern Emergency Medical Transportation Corporation, Manteca District Volunteer Ambulance Service, Patterson District Ambulance, Piner's Ambulance, Inc., Progressive Ambulance, Inc., Riggs Ambulance Service, Inc., San Luis Ambulance Service, Inc., Schaefer Ambulance Service, Inc., Sierra Ambulance Service, Inc., Sierra Lifestar, Inc., Sierra Medical Services Alliance. (Warren, Kevin) (Entered: 05/02/2012)
58 NOTICE OF MOTION AND MOTION for Leave to file A First Amended Complaint And Motion To Lift Stay filed by Plaintiffs American Ambulance of Visalia, American Legion Post 108 Ambulance Service, Care Ambulance Service, Inc., Care Flight, City Ambulance of Eureka, Inc., Community Ambulance Services, Inc., Del Norte Ambulance, Inc., Delano Ambulance Service, Inc., Desert Ambulance Service, Exeter District Ambulance, First Responder Emergency Medical Services, Inc., First Responder Emergency Medical Services−Sacramento, Inc., Hall Ambulance Service, Inc., Imperial Ambulance Services, Inc., K.W.P.H. Enterprises, Kern Emergency Medical Transportation Corporation, Manteca District Volunteer Ambulance Service, Patterson District Ambulance, Piner's Ambulance, Inc., Progressive Ambulance, Inc., Riggs Ambulance Service, Inc., San Luis Ambulance Service, Inc., Schaefer Ambulance Service, Inc., Sierra Ambulance Service, Inc., Sierra Lifestar, Inc., Sierra Medical Services Alliance. Motion set for hearing on 9/10/2012 at 10:00 AM before Judge Christina A. Snyder. (Attachments: # 1 Exhibit A − [Proposed] First Amended Complaint, # 2 Exhibit B − [Proposed] Order)(Warren, Kevin) (Entered: 08/02/2012)
59 DECLARATION of Kevin R. Warren In Support Of MOTION for Leave to file A First Amended Complaint And Motion To Lift Stay 58 filed by Plaintiffs American Ambulance of Visalia, American Legion Post 108 Ambulance Service, Care Ambulance Service, Inc., Care Flight, City Ambulance of Eureka, Inc., Community Ambulance Services, Inc., Del Norte Ambulance, Inc., Delano Ambulance Service, Inc., Desert Ambulance Service, Exeter District Ambulance, First Responder Emergency Medical Services, Inc., First Responder Emergency Medical Services−Sacramento, Inc., Hall Ambulance Service, Inc., Imperial Ambulance Services, Inc., K.W.P.H. Enterprises, Kern Emergency Medical Transportation Corporation, Manteca District Volunteer Ambulance Service, Patterson District Ambulance, Piner's Ambulance, Inc., Progressive Ambulance, Inc., Riggs Ambulance Service, Inc., San Luis Ambulance Service, Inc., Schaefer Ambulance Service, Inc., Sierra Ambulance Service, Inc., Sierra Lifestar, Inc., Sierra Medical Services Alliance. (Attachments: # 1 Exhibit A, # 2 Exhibit B, # 3 Exhibit C, # 4 Exhibit D, # 5 Exhibit E)(Warren, Kevin) (Entered: 08/02/2012)
60 OPPOSITION to MOTION for Leave to file A First Amended Complaint And Motion To Lift Stay 58 Defendants' Response to Plaintiffs' Consolidated Motion to File an Amended Complaint and Lift Stay filed by Defendants California Department of Health Care Services, David Maxwell−Jolly. (Stanton, Hadara) (Entered: 08/17/2012)
61 NOTICE TO FILER OF DEFICIENCIES in Electronically Filed Documents RE: Plaintiffs' Consolidated Motion for Orders (1) Granting Leave to file A First Amended Complaint; and (2) To Lift Stay and Place Case on Court's Active List filed 8/2/2012 58 . The following error(s) was found: Incorrect event selected. The correct event is: Motions − (1) Leave to File Document; (2) Stay Case (to Lift). Filer docketed this multi−part motion with the event Motions − Leave to File Document, only. The separately attached proposed order lacks at least two lines of text on the page that has the line provided for the signature of the judge, Local Rule 58−10. In response to this

Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 22 of 33

08/27/2012
08/29/2012 09/04/2012 09/10/2012 09/11/2012 09/20/2012

notice the court may order (1) an amended or correct document to be filed (2) the document stricken or (3) take other action as the court deems appropriate. You need not take any action in response to this notice unless and until the court directs you to do so. (gk) (Entered: 08/20/2012)
62 REPLY in support of MOTION for Leave to file A First Amended Complaint And Motion To Lift Stay 58 filed by Plaintiffs American Ambulance of Visalia, American Legion Post 108 Ambulance Service, Care Ambulance Service, Inc., Care Flight, City Ambulance of Eureka, Inc., Community Ambulance Services, Inc., Del Norte Ambulance, Inc., Delano Ambulance Service, Inc., Desert Ambulance Service, Exeter District Ambulance, First Responder Emergency Medical Services, Inc., First Responder Emergency Medical Services−Sacramento, Inc., Hall Ambulance Service, Inc., Imperial Ambulance Services, Inc., K.W.P.H. Enterprises, Kern Emergency Medical Transportation Corporation, Manteca District Volunteer Ambulance Service, Patterson District Ambulance, Piner's Ambulance, Inc., Progressive Ambulance, Inc., Riggs Ambulance Service, Inc., San Luis Ambulance Service, Inc., Schaefer Ambulance Service, Inc., Sierra Ambulance Service, Inc., Sierra Lifestar, Inc., Sierra Medical Services Alliance. (Warren, Kevin) (Entered: 08/27/2012)
63 REQUEST for Leave of Hadara R. Stanton to Appear for Hearing on Plaintiffs' Consolidated Motion for Orders (1) Granting Leave to File a First Amended Complaint and (2) To Lift Stay and Place Case on Court's Active List filed by Defendants California Department of Health Care Services, David Maxwell−Jolly. Request set for hearing on 9/10/2012 at 10:00 AM before Judge Christina A. Snyder. (Attachments: # 1 Proposed Order [Proposed] Order Granting Defendants' Request to Appear by Telephone at the September 10, 2012 Hearing)(Stanton, Hadara) (Entered: 08/29/2012)
64 ORDER GRANTING DEFENDANTS REQUEST TO APPEAR BY TELEPHONE AT THE SEPTEMBER 10, 2012 HEARING by Judge Christina A. Snyder 63 . (im) (Entered: 09/05/2012)
65 MINUTES: PLAINTIFFS CONSOLIDATED MOTION FOR ORDERS: 1) GRANTING LEAVE TO FILE A FIRST AMENDED COMPLAINT; AND 2) TO LIFT STAY AND PLACE CASE ON COURT'S ACTIVE LIST (Filed 08/02/12) 58 : Hearing held and counsel are present. The Court confers with counsel and the Court grants the above−referenced motion. Plaintiffs' shall file a First Amended Complaint forthwith. The Court hereby lifts the stay and places the above−referenced action back on its active caseload by Judge Christina A. Snyder:; (Case reopened. MD JS−5.)Court Reporter: Laura Elias. (ir) (Entered: 09/12/2012)
66 ORDER: (1) GRANTING LEAVE TO FILE A FIRST AMENDED COMPLAINT; (2) LIFTING STAY AND PLACE CASE ON COURT'S ACTIVE LIST by Judge Christina A. Snyder: Upon Plaintiffs' Consolidated Motion 58 , the Court hereby orders as follows: (1) Plaintiffs may file a First Amended Complaint with ten days; the stay of the proceedings currently in effect is lifted. (gk) (Entered: 09/13/2012)
67 FIRST AMENDED COMPLAINT against Defendants David Maxwell−Jolly, former Director of the Department of Health Care Services of the State of California, and Toby Douglas, Director of the Department of Health Care Services of the State of California; Party California Department of Health Care Services terminated; amending Complaint 1 ; with Jury Demand filed by Plaintiffs Sierra Medical Services Alliance, Care Flight, Riggs Ambulance Service, Inc., Schaefer Ambulance Service, Inc., American Ambulance of Visalia, Desert Ambulance Service, San Luis Ambulance Service, Inc., First Responder Emergency Medical Services−Sacramento, Inc., First Responder Emergency Medical Services, Inc., Imperial Ambulance Services, Inc., Exeter District Ambulance, Sierra Lifestar, Inc. d.b.a Lifestar Ambulance, Del Norte Ambulance, Inc., Piner's Ambulance, Inc., American Legion Post 108 Ambulance Service, Progressive Ambulance, Inc. d.b.a Liberty Ambulance, Hall Ambulance Service, Inc., City Ambulance of Eureka, Inc., Patterson District Ambulance, K.W.P.H. Enterprises d.b.a. Amberican Ambulance, Community Ambulance Services, Inc., Sierra Ambulance Service, Inc., Care Ambulance Service, Inc., Delano Ambulance Service, Inc., Kern Emergency Medical Transportation Corporation d.b.a. Kern Ambulance, Manteca District Volunteer Ambulance Service d.b.a. Manteca District Ambulance Service, California Ambulance Association, Regional Emergency Medical Services Authority, Metro West Ambulance Service, Inc., and Westmed

Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 23 of 33

09/20/2012 10/02/2012
10/02/2012
10/04/2012 10/04/2012 10/04/2012 10/10/2012

Ambulance, Inc. d.b.a. McCormick Ambulance. (Attachments: # 1 Issued Summons on First Amended Complaint)(gk) (Entered: 09/21/2012)
21−Day Summons Issued re First Amended Complaint 67 as to Defendants David Maxwell−Jolly, former Director of the Department of Health Care Services of the State of California, and Toby Douglas, Director of the Department of Health Care Services of the State of California. (gk) (Entered: 09/21/2012)
68 WAIVER OF SERVICE Returned Executed filed by plaintiffs Sierra Ambulance Service, Inc., Care Ambulance Service, Inc., Riggs Ambulance Service, Inc., Regional Emergency Medical Services Authority, Manteca District Volunteer Ambulance Service, Sierra Medical Services Alliance, Desert Ambulance Service, American Legion Post 108 Ambulance Service, First Responder Emergency Medical Services, Inc., Imperial Ambulance Services, Inc., Patterson District Ambulance, Schaefer Ambulance Service, Inc., Exeter District Ambulance, California Ambulance Association, First Responder Emergency Medical Services−Sacramento, Inc., Metro West Ambulance Service, Inc., American Ambulance of Visalia, Community Ambulance Services, Inc., Hall Ambulance Service, Inc., Piner's Ambulance, Inc., Progressive Ambulance, Inc., Del Norte Ambulance, Inc., K.W.P.H. Enterprises, Care Flight, Sierra Lifestar, Inc., Delano Ambulance Service, Inc., Kern Emergency Medical Transportation Corporation, San Luis Ambulance Service, Inc., Westmed Ambulance, Inc., City Ambulance of Eureka, Inc.. upon Toby Douglas waiver sent by Plaintiff on 9/21/2012, answer due 11/20/2012. Waiver of Service signed by Hadara Stanton. (Warren, Kevin) (Entered: 10/02/2012)
69 WAIVER OF SERVICE Returned Executed filed by plaintiffs Sierra Ambulance Service, Inc., Care Ambulance Service, Inc., Riggs Ambulance Service, Inc., Regional Emergency Medical Services Authority, Manteca District Volunteer Ambulance Service, Sierra Medical Services Alliance, Desert Ambulance Service, American Legion Post 108 Ambulance Service, First Responder Emergency Medical Services, Inc., Imperial Ambulance Services, Inc., Patterson District Ambulance, Schaefer Ambulance Service, Inc., Exeter District Ambulance, California Ambulance Association, First Responder Emergency Medical Services−Sacramento, Inc., Metro West Ambulance Service, Inc., American Ambulance of Visalia, Community Ambulance Services, Inc., Hall Ambulance Service, Inc., Piner's Ambulance, Inc., Progressive Ambulance, Inc., Del Norte Ambulance, Inc., K.W.P.H. Enterprises, Care Flight, Sierra Lifestar, Inc., Delano Ambulance Service, Inc., Kern Emergency Medical Transportation Corporation, San Luis Ambulance Service, Inc., Westmed Ambulance, Inc., City Ambulance of Eureka, Inc.. upon David Maxwell−Jolly waiver sent by Plaintiff on 9/21/2012, answer due 11/20/2012. Waiver of Service signed by Hadara Stanton. (Warren, Kevin) (Entered: 10/02/2012)
70 NOTICE OF MOTION AND MOTION to Dismiss Case Defendants' Notice of Motion and Motion to Dismiss First Amended Complaint (Fed. R. Civ. P. 12 (B)(1) & (6) and Memorandum in Support filed by Defendants Toby Douglas, David Maxwell−Jolly. Motion set for hearing on 11/5/2012 at 10:00 AM before Judge Christina A. Snyder. (Attachments: # 1 Proposed Order [proposed] Order Granting Defendants' Motion to Dismiss)(Stanton, Hadara) (Entered: 10/04/2012)
71 REQUEST FOR JUDICIAL NOTICE Defendants' Request for Judicial Notice in Support of Motion to Dismiss filed by Defendants Toby Douglas, David Maxwell−Jolly. (Attachments: # 1 Exhibit A, # 2 Exhibit B, # 3 Exhibit C, # 4 Exhibit D)(Stanton, Hadara) (Entered: 10/04/2012)
72 OBJECTIONS to Amended Complaint,,,,,, 67 Defendants'Objection to the Filed First Amended Complaint filed by Defendants Toby Douglas, David Maxwell−Jolly. (Attachments: # 1 Exhibit Attachment 1, # 2 Exhibit Attachment 2)(Stanton, Hadara) (Entered: 10/04/2012)
73 STIPULATION to Continue Motion to Dismiss from November 5, 2012 to December 10, 2012 filed by plaintiffs American Ambulance of Visalia, American Legion Post 108 Ambulance Service, California Ambulance Association, Care Ambulance Service, Inc., Care Flight, City Ambulance of Eureka, Inc., Community Ambulance Services, Inc., Del Norte Ambulance, Inc., Delano Ambulance Service, Inc., Desert Ambulance Service, Exeter District Ambulance, First Responder Emergency Medical Services, Inc., First Responder Emergency Medical Services−Sacramento, Inc., Hall Ambulance

Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 24 of 33

10/11/2012 11/13/2012
11/26/2012 12/10/2012 12/28/2012
01/17/2013

Service, Inc., Imperial Ambulance Services, Inc., K.W.P.H. Enterprises, Kern Emergency Medical Transportation Corporation, Manteca District Volunteer Ambulance Service, Metro West Ambulance Service, Inc., Patterson District Ambulance, Piner's Ambulance, Inc., Progressive Ambulance, Inc., Regional Emergency Medical Services Authority, Riggs Ambulance Service, Inc., San Luis Ambulance Service, Inc., Schaefer Ambulance Service, Inc., Sierra Ambulance Service, Inc., Sierra Lifestar, Inc., Sierra Medical Services Alliance, Westmed Ambulance, Inc.. (Attachments: # 1 Proposed Order Granting Stipulation to Continue Motion to Dismiss)(Warren, Kevin) (Entered: 10/10/2012)
74 ORDER GRANTING STIPULATION TO CONTINUE HEARING ON DEFENDANTS MOTIONS TO DISMISS by Judge Christina A. Snyder 73 . The hearing date of Defendants Motion will be moved from November 5, 2012 to December 10, 2012. SEE ORDER FOR OTHER DEADLINES. (im) (Entered: 10/12/2012)
75 OPPOSITION to Defendants' Motion to Dismiss Complaint filed by Plaintiffs American Ambulance of Visalia, American Legion Post 108 Ambulance Service, California Ambulance Association, Care Ambulance Service, Inc., Care Flight, City Ambulance of Eureka, Inc., Community Ambulance Services, Inc., Del Norte Ambulance, Inc., Delano Ambulance Service, Inc., Desert Ambulance Service, Exeter District Ambulance, First Responder Emergency Medical Services, Inc., First Responder Emergency Medical Services−Sacramento, Inc., Hall Ambulance Service, Inc., Imperial Ambulance Services, Inc., K.W.P.H. Enterprises, Kern Emergency Medical Transportation Corporation, Manteca District Volunteer Ambulance Service, Metro West Ambulance Service, Inc., Patterson District Ambulance, Piner's Ambulance, Inc., Progressive Ambulance, Inc., Regional Emergency Medical Services Authority, Riggs Ambulance Service, Inc., San Luis Ambulance Service, Inc., Schaefer Ambulance Service, Inc., Sierra Ambulance Service, Inc., Sierra Lifestar, Inc., Sierra Medical Services Alliance, Westmed Ambulance, Inc., Defendant California Department of Health Care Services. (Attachments: # 1 Declaration Declaration of Kevin R. Warren, # 2 Supplement Plaintiff Request for Judicial Notice)(Warren, Kevin) (Entered: 11/13/2012)
76 REPLY Defendants' Reply to Plaintiffs' Opposition to Motion to Dismiss filed by Defendants Toby Douglas, David Maxwell−Jolly. (Stanton, Hadara) (Entered: 11/26/2012)
77 MINUTES OF Motion Hearing held before Judge Christina A. Snyder: Defendants' Motion to Dismiss 70 is GRANTED in part and DENIED in part without prejudice. Plaintiffs shall have 20 days to file an amended complaint addressing the deficiencies identified herein. Court Reporter: Laura Elias. (gk) (Entered: 12/11/2012)
78 NOTICE filed by Plaintiffs American Ambulance of Visalia, American Legion Post 108 Ambulance Service, California Ambulance Association, California Department of Health Care Services, Care Ambulance Service, Inc., Care Flight, City Ambulance of Eureka, Inc., Community Ambulance Services, Inc., Del Norte Ambulance, Inc., Delano Ambulance Service, Inc., Desert Ambulance Service, Exeter District Ambulance, First Responder Emergency Medical Services, Inc., First Responder Emergency Medical Services−Sacramento, Inc., Hall Ambulance Service, Inc., Imperial Ambulance Services, Inc., K.W.P.H. Enterprises, Kern Emergency Medical Transportation Corporation, Manteca District Volunteer Ambulance Service, Metro West Ambulance Service, Inc., Patterson District Ambulance, Piner's Ambulance, Inc., Progressive Ambulance, Inc., Regional Emergency Medical Services Authority, Riggs Ambulance Service, Inc., San Luis Ambulance Service, Inc., Schaefer Ambulance Service, Inc., Sierra Ambulance Service, Inc., Sierra Lifestar, Inc., Sierra Medical Services Alliance, Westmed Ambulance, Inc.. NOTICE RE: COURT'S ORDER DATED DECEMBER 10, 2012 AND REQUEST FOR STATUS CONFERENCE (Warren, Kevin) (Entered: 12/28/2012)
79 MINUTE ORDER IN CHAMBERS by Judge Christina A. Snyder 78 . The Court is in receipt of the above−referenced document. The Court sets a SchedulingConference on March 25, 2013, at 11:00 a.m. The Scheduling Conference will be held pursuant to F.R.Civ.P 16(b). The parties are reminded of their obligations to disclose information and confer on a discovery plan not later than 21 days prior to the date of the Rule 16(b) Scheduling Conference and to report to the Court not later than 14 days after they

Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 25 of 33

02/27/2013 02/27/2013 02/27/2013 03/13/2013
03/25/2013 04/02/2013 04/05/2013 04/12/2013

confer on a discovery plan and the other matters required by F.R.Civ.P. 26(f) and the Local Rules of this Court.SEE ORDER. (im) (Entered: 01/17/2013)
80 ANSWER to Amended Complaint,,,,,, 67 Defendants' Answer to the First Amended Complaint filed by Defendants California Department of Health Care Services, Toby Douglas, David Maxwell−Jolly.(Stanton, Hadara) (Entered: 02/27/2013)
81 REQUEST for Leave to to appear by telephone filed by Defendants Toby Douglas, David Maxwell−Jolly. Request set for hearing on 3/25/2013 at 11:00 AM before Judge Christina A. Snyder. (Attachments: # 1 Proposed Order)(Stanton, Hadara) (Entered: 02/27/2013)
82 ORDER GRANTING DEFENDANTS REQUEST TO APPEAR BY TELEPHONE AT MARCH 25, 2013 SCHEDULING CONFERENCE by Judge Christina A. Snyder 81 . The Court shall contact Defendants counsel for the Scheduling Conference on March 25, 2013. (im) (Entered: 02/27/2013)
83 JOINT SCHEDULING CONFERENCE REPORT filed by Plaintiffs American Ambulance of Visalia, American Legion Post 108 Ambulance Service, California Ambulance Association, Care Ambulance Service, Inc., Care Flight, City Ambulance of Eureka, Inc., Community Ambulance Services, Inc., Del Norte Ambulance, Inc., Delano Ambulance Service, Inc., Desert Ambulance Service, Exeter District Ambulance, First Responder Emergency Medical Services, Inc., First Responder Emergency Medical Services−Sacramento, Inc., Hall Ambulance Service, Inc., Imperial Ambulance Services, Inc., K.W.P.H. Enterprises, Kern Emergency Medical Transportation Corporation, Manteca District Volunteer Ambulance Service, Metro West Ambulance Service, Inc., Patterson District Ambulance, Piner's Ambulance, Inc., Progressive Ambulance, Inc., Regional Emergency Medical Services Authority, Riggs Ambulance Service, Inc., San Luis Ambulance Service, Inc., Schaefer Ambulance Service, Inc., Sierra Ambulance Service, Inc., Sierra Lifestar, Inc., Sierra Medical Services Alliance, Westmed Ambulance, Inc., Defendants California Department of Health Care Services, Toby Douglas, David Maxwell−Jolly. (Warren, Kevin) (Entered: 03/13/2013)
84 MINUTES OF Scheduling Conference held before Judge Christina A. Snyder: Hearing held and counsel are present. The Court confers with counsel and schedules the following dates: Amended Pleadings due by 4/30/2013. Discovery cut−off 10/21/2013. Motions due by 10/25/2013. Final Pretrial Conference set for 1/6/2014 at 11:00 AM. Jury Trial set for 2/11/2014 at 09:30 AM. The Court defers discussions regarding settlement procedures until the hearing on Summary Judgment in the above−referenced action.Court Reporter: Sheri Kleeger. (ms) (Entered: 03/26/2013)
85 NOTICE OF REASSIGNMENT of California Attorney General Office Hadara R. Stanton on behalf of Defendant Toby Douglas, David Maxwell−Jolly. California Attorney General Nimrod P Elias; Jennifer M Kim; Leslie P McElroy; Tara L Newman; Richard T Waldow; Tracey L Angelopoulos and Chara L Crane terminated. (Stanton, Hadara) (Entered: 04/02/2013)
86 Initial DISCLOSURE of Rule 26 Disclosures filed by Defendant Toby Douglas (Stanton, Hadara) (Entered: 04/05/2013)
87 INITIAL DISCLOSURE PURSUANT TO RULE 26 filed by Plaintiffs American Ambulance of Visalia, American Legion Post 108 Ambulance Service, California Ambulance Association, Care Ambulance Service, Inc., Care Flight, City Ambulance of Eureka, Inc., Community Ambulance Services, Inc., Del Norte Ambulance, Inc., Delano Ambulance Service, Inc., Desert Ambulance Service, Exeter District Ambulance, First Responder Emergency Medical Services, Inc., First Responder Emergency Medical Services−Sacramento, Inc., Hall Ambulance Service, Inc., Imperial Ambulance Services, Inc., K.W.P.H. Enterprises, Kern Emergency Medical Transportation Corporation, Manteca District Volunteer Ambulance Service, Metro West Ambulance Service, Inc., Patterson District Ambulance, Piner's Ambulance, Inc., Progressive Ambulance, Inc., Regional Emergency Medical Services Authority, Riggs Ambulance Service, Inc., San Luis Ambulance Service, Inc., Schaefer Ambulance Service, Inc., Sierra Ambulance Service, Inc., Sierra Lifestar, Inc., Sierra Medical Services Alliance, Westmed Ambulance, Inc. (Warren, Kevin) (Entered: 04/12/2013)

Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 26 of 33

09/27/2013 10/14/2013
10/14/2013 10/15/2013 10/17/2013

88 Notice of Appearance or Withdrawal of Counsel: for attorney Kelly M Hagemann counsel for Plaintiffs American Ambulance of Visalia, American Legion Post 108 Ambulance Service, California Ambulance Association, Care Ambulance Service, Inc., Care Flight, City Ambulance of Eureka, Inc., Community Ambulance Services, Inc., Del Norte Ambulance, Inc., Delano Ambulance Service, Inc., Desert Ambulance Service, Exeter District Ambulance, First Responder Emergency Medical Services, Inc., First Responder Emergency Medical Services−Sacramento, Inc., Hall Ambulance Service, Inc., Imperial Ambulance Services, Inc., K.W.P.H. Enterprises, Kern Emergency Medical Transportation Corporation, Manteca District Volunteer Ambulance Service, Metro West Ambulance Service, Inc., Patterson District Ambulance, Piner's Ambulance, Inc., Progressive Ambulance, Inc., Regional Emergency Medical Services Authority, Riggs Ambulance Service, Inc., San Luis Ambulance Service, Inc., Schaefer Ambulance Service, Inc., Sierra Ambulance Service, Inc., Sierra Lifestar, Inc., Sierra Medical Services Alliance, Westmed Ambulance, Inc.. Adding Kelly M. Hagemann as attorney as counsel of record for Plaintiffs for the reason indicated in the G−123 Notice. Filed by Plaintiffs Sierra Medical Services Alliance, et al. (Hagemann, Kelly) (Entered: 09/27/2013)
89 NOTICE OF MOTION AND MOTION to Compel Defendant to (1) Produce Witnesses for Deposition; (2) Respond to Interrogatories; and (3) Respond to Requests for Production filed by Plaintiffs American Ambulance of Visalia, American Legion Post 108 Ambulance Service, California Ambulance Association, Care Ambulance Service, Inc., Care Flight, City Ambulance of Eureka, Inc., Community Ambulance Services, Inc., Del Norte Ambulance, Inc., Delano Ambulance Service, Inc., Desert Ambulance Service, Exeter District Ambulance, First Responder Emergency Medical Services, Inc., First Responder Emergency Medical Services−Sacramento, Inc., Hall Ambulance Service, Inc., Imperial Ambulance Services, Inc., K.W.P.H. Enterprises, Kern Emergency Medical Transportation Corporation, Manteca District Volunteer Ambulance Service, Metro West Ambulance Service, Inc., Patterson District Ambulance, Piner's Ambulance, Inc., Progressive Ambulance, Inc., Regional Emergency Medical Services Authority, Riggs Ambulance Service, Inc., San Luis Ambulance Service, Inc., Schaefer Ambulance Service, Inc., Sierra Ambulance Service, Inc., Sierra Lifestar, Inc., Sierra Medical Services Alliance, Westmed Ambulance, Inc.. Motion set for hearing on 11/5/2013 at 10:00 AM before Magistrate Judge Margaret A. Nagle. (Attachments: # 1 Joint Stipulation, # 2 Declaration of Kelly M. Hagemann and Exhs. A−E, # 3 Declaration of Kevin R. Warren and Exhs F−I, # 4 Exhibit Exhs−J−L to Warren Dec, # 5 Exhibit Exhs−M−Q to Warren Dec, # 6 Proposed Order)(Hagemann, Kelly) (Entered: 10/14/2013)
90 EX PARTE APPLICATION to Compel depositions of Defendants employees and an order enforcing Defendants stipulation; or, an Order shortening time on the noticed motion compelling the same 89 filed by Plaintiffs American Ambulance of Visalia, American Legion Post 108 Ambulance Service, California Ambulance Association, Care Ambulance Service, Inc., Care Flight, City Ambulance of Eureka, Inc., Community Ambulance Services, Inc., Del Norte Ambulance, Inc., Delano Ambulance Service, Inc., Desert Ambulance Service, Exeter District Ambulance, First Responder Emergency Medical Services, Inc., First Responder Emergency Medical Services−Sacramento, Inc., Hall Ambulance Service, Inc., Imperial Ambulance Services, Inc., K.W.P.H. Enterprises, Kern Emergency Medical Transportation Corporation, Manteca District Volunteer Ambulance Service, Metro West Ambulance Service, Inc., Patterson District Ambulance, Piner's Ambulance, Inc., Progressive Ambulance, Inc., Regional Emergency Medical Services Authority, Riggs Ambulance Service, Inc., San Luis Ambulance Service, Inc., Schaefer Ambulance Service, Inc., Sierra Ambulance Service, Inc., Sierra Lifestar, Inc., Sierra Medical Services Alliance, Westmed Ambulance, Inc.. (Attachments: # 1 Declaration of Kelly M. Hagemann, # 2 Proposed Order)(Hagemann, Kelly) (Entered: 10/14/2013)
91 Defendant's Opposition to Plaintiffs' Ex Parte Application 90 re: EX PARTE APPLICATION to Compel depositions of Defendants employees and an order enforcing Defendants stipulation; or, an Order shortening time on the noticed motion compelling the same 89 90 filed by Defendant Toby Douglas. (Stanton, Hadara) (Entered: 10/15/2013)
92 NOTICE by Magistrate Judge Margaret A. Nagle scheduling a telephonic hearing re: Ex Parte Application to Compel 90 for 10/18/2013 at 10:00 AM before Magistrate Judge Margaret A. Nagle. The Court will initiate the call with counsel. Counsel shall

Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 27 of 33

10/18/2013 10/25/2013
10/25/2013 10/25/2013 10/25/2013 10/25/2013 10/25/2013

notify the Court Clerk via email at earlene_carson@cacd.uscourts.gov of the names of counsel appearing and the telephone number(s) at which counsel may be contacted for the call.THERE IS NO PDF DOCUMENT ASSOCIATED WITH THIS ENTRY. (ec) TEXT ONLY ENTRY (Entered: 10/17/2013)
93 MINUTES OF Discovery Hearing held before Magistrate Judge Margaret A. Nagle:denying 90 Ex Parte Application to Compel and taking off calendar Plaintiffs' Motion To Compel scheduled for 11/5/2013.Court Recorder: CS. (ec) (Entered: 10/21/2013)
94 COMPACT DISC Order for date of proceedings 10/18/2013 to 10/18/2013 re: Order on Ex Parte Application to Compel, Discovery Hearing, Terminate Hearings 93 , filed by Plaintiffs American Ambulance of Visalia, American Legion Post 108 Ambulance Service, California Ambulance Association, Care Ambulance Service, Inc., Care Flight, City Ambulance of Eureka, Inc., Community Ambulance Services, Inc., Del Norte Ambulance, Inc., Delano Ambulance Service, Inc., Desert Ambulance Service, Exeter District Ambulance, First Responder Emergency Medical Services, Inc., First Responder Emergency Medical Services−Sacramento, Inc., Hall Ambulance Service, Inc., Imperial Ambulance Services, Inc., K.W.P.H. Enterprises, Kern Emergency Medical Transportation Corporation, Manteca District Volunteer Ambulance Service, Metro West Ambulance Service, Inc., Patterson District Ambulance, Piner's Ambulance, Inc., Progressive Ambulance, Inc., Regional Emergency Medical Services Authority, Riggs Ambulance Service, Inc., San Luis Ambulance Service, Inc., Schaefer Ambulance Service, Inc., Sierra Ambulance Service, Inc., Sierra Lifestar, Inc., Sierra Medical Services Alliance, Westmed Ambulance, Inc.. Court will contact Kelly Hagemann, Esq. at khagemann@mrllp.com with any questions regarding this order. Transcript portion requested: Opinion of the Court on 10/18/2013. Other: Telephonic Hearing Re Plaintiffs' Ex Parte Application to Compel Depositions of Defendant's Employees and an Order Enforcing Defendant's Stipulation, or an Order Shortening Time on the Noticed Motion Compelling the Same ("Ex Parte Application") 10/18/2013. FEE PAID. (Hagemann, Kelly) (Entered: 10/25/2013)
95 NOTICE OF MOTION AND MOTION for Summary Judgment Memorandum of Points and Authorities In Support filed by Defendant Toby Douglas. Motion set for hearing on 11/25/2013 at 10:00 AM before Judge Christina A. Snyder. (Attachments: # 1 Proposed Order Proposed Judgment and Order Granting Defendant's Motion for Summary Judgment)(Stanton, Hadara) (Entered: 10/25/2013)
96 STATEMENT of of Uncontroverted Facts and Conclusions of Law In Support of Defendant's Motion for Summary Judgment MOTION for Summary Judgment Memorandum of Points and Authorities In Support 95 filed by Defendant Toby Douglas. (Stanton, Hadara) (Entered: 10/25/2013)
97 REQUEST FOR JUDICIAL NOTICE re MOTION for Summary Judgment Memorandum of Points and Authorities In Support 95 filed by Defendant Toby Douglas. (Attachments: # 1 Proposed Order Proposed Order Granting Defendant's Request for Judicial Notice in Support of Defendant's Motion for Summary Judgment, # 2 Exhibit Exhibit 1, # 3 Exhibit Exhibit 2, # 4 Exhibit Exhibit 3, # 5 Exhibit Exhibit 4, # 6 Exhibit Exhibit 5, # 7 Exhibit Exhibit 6, # 8 Exhibit Exhibit 7)(Stanton, Hadara) (Entered: 10/25/2013)
98 EXHIBIT 8 through 16 relating to Defendant's Request for Judicial Notice In Support of Motion for Summary Judgment Doc. 97 to MOTION for Summary Judgment Memorandum of Points and Authorities In Support 95 filed by Defendant Toby Douglas. (Attachments: # 1 Exhibit Exhibit 9, # 2 Exhibit Exhibit 10, # 3 Exhibit Exhibit 11, # 4 Exhibit Exhibit 12, # 5 Exhibit Exhibit 13, # 6 Exhibit Exhibit 14, # 7 Exhibit Exhibit 15, # 8 Exhibit Exhibit 16)(Stanton, Hadara) (Entered: 10/25/2013)
99 EXHIBIT 17 through 20 attachments to Defendant's Request for Judicial Notice in Support of Motion for Summary Judgment (filed Doc. 97) to MOTION for Summary Judgment Memorandum of Points and Authorities In Support 95 filed by Defendant Toby Douglas. (Attachments: # 1 Exhibit Exhibit 18 Part 1 of 3, # 2 Exhibit Exhibit 18 Part 2 of 3, # 3 Exhibit Exhibit 18 Part 3 of 3, # 4 Exhibit Exhibit 19 Part 1 of 5, # 5 Exhibit Exhibit 19 Part 2 of 5, # 6 Exhibit Exhibit 19 Part 3 of 5, # 7 Exhibit Exhibit 19 Part 4 of 5, # 8 Exhibit Exhibit 19 Part 5 of 5, # 9 Exhibit Exhibit 20)(Stanton, Hadara) (Entered: 10/25/2013)

Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 28 of 33

11/04/2013
11/05/2013 11/12/2013 11/12/2013 01/24/2014

100 MEMORANDUM in Opposition to MOTION for Summary Judgment Memorandum of Points and Authorities In Support 95 filed by Plaintiffs American Ambulance of Visalia, American Legion Post 108 Ambulance Service, California Ambulance Association, Care Ambulance Service, Inc., Care Flight, City Ambulance of Eureka, Inc., Community Ambulance Services, Inc., Del Norte Ambulance, Inc., Delano Ambulance Service, Inc., Desert Ambulance Service, Exeter District Ambulance, First Responder Emergency Medical Services, Inc., First Responder Emergency Medical Services−Sacramento, Inc., Hall Ambulance Service, Inc., Imperial Ambulance Services, Inc., K.W.P.H. Enterprises, Kern Emergency Medical Transportation Corporation, Manteca District Volunteer Ambulance Service, Metro West Ambulance Service, Inc., Patterson District Ambulance, Piner's Ambulance, Inc., Progressive Ambulance, Inc., Regional Emergency Medical Services Authority, Riggs Ambulance Service, Inc., San Luis Ambulance Service, Inc., Schaefer Ambulance Service, Inc., Sierra Ambulance Service, Inc., Sierra Lifestar, Inc., Sierra Medical Services Alliance, Westmed Ambulance, Inc.. (Attachments: # 1 Supplement Plaintiffs' Statement Of Genuine Disputes Of Material Facts In Opposition To Defendant's Motion For Summary Judgment, # 2 Supplement Plaintiffs' Objections To Evidence In Opposition To Defendant's Motion For Summary Judgment, # 3 Declaration Of Kelly M. Hagemann In Support Of Opposition To Defendant's Motion For Summary Judgment, # 4 Exhibit A − C To Declaration of Kelly M. Hagemann, # 5 Exhibit D To Declaration of Kelly M. Hagemann, # 6 Exhibit E − H To Declaration of Kelly M. Hagemann, # 7 Declaration Of Brenda Staffan In Support Of Opposition To Defendant's Motion For Summary Judgment, # 8 Declaration Of Henry W. Zaretsky In Support Of Opposition To Defendant's Motion For Summary Judgment, # 9 Proposed Order Denying Defendant's Motion For Summary Judgment)(Hagemann, Kelly) (Entered: 11/04/2013)
101 MINUTES (IN CHAMBERS) STAY OF PROCEEDINGS by Judge Christina A. Snyder: By order dated 7/8/2013, the Court directed the parties in these matters to submit a joint status report. Dkt. #242, in case no. 2:11−CV−09688−CAS(MANx). The joint status report was filed on 7/23/2013. Dkt. #243, in case no. 2:11−CV−09688−CAS(MANx). The Court has reviewed the parties' positions set forth therein, as well as the issues presented by the petition for writ of certiorari now pending in the United States Supreme Court, see Supreme Court Docket No. 13−253. Based on the foregoing, the Court finds that there is good cause to stay the proceedings or, if applicable, to continue the existing stay of the proceedings in the above−entitled cases, pending notification from this Court. The parties are directed to file a joint status report with this Court within 14 days after the Supreme Court has taken any action with respect to the above−referenced petition for writ of certiorari. (Made JS−6. Case Terminated.) Court Reporter: Not Present. (gk) (Entered: 11/06/2013)
102 NOTICE TO FILER OF DEFICIENCIES in Electronically Filed Documents RE: Exhibit 8 through 16 re Defendant's Request for Judicial Notice filed 10/25/2013 98 . The following error(s) was found: Title page is missing. In response to this notice the court may order (1) an amended or correct document to be filed (2) the document stricken or (3) take other action as the court deems appropriate. You need not take any action in response to this notice unless and until the court directs you to do so. (gk) (Entered: 11/13/2013)
103 NOTICE TO FILER OF DEFICIENCIES in Electronically Filed Documents RE: Exhibit 17 through 20 re Defendant's Request for Judicial Notice filed 10/25/2013 99 . The following error(s) was found: Title page is missing. In response to this notice the court may order (1) an amended or correct document to be filed (2) the document stricken or (3) take other action as the court deems appropriate. You need not take any action in response to this notice unless and until the court directs you to do so. (gk) (Entered: 11/13/2013)
104 JOINT STATUS REPORT filed by Plaintiffs American Ambulance of Visalia, American Legion Post 108 Ambulance Service, California Ambulance Association, Care Ambulance Service, Inc., Care Flight, City Ambulance of Eureka, Inc., Community Ambulance Services, Inc., Del Norte Ambulance, Inc., Delano Ambulance Service, Inc., Desert Ambulance Service, Exeter District Ambulance, First Responder Emergency Medical Services, Inc., First Responder Emergency Medical Services−Sacramento, Inc., Hall Ambulance Service, Inc., Imperial Ambulance Services, Inc., K.W.P.H. Enterprises, Kern Emergency Medical Transportation Corporation, Manteca District Volunteer Ambulance Service, Metro West Ambulance

Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 29 of 33

01/30/2014 01/30/2014 01/30/2014 01/31/2014 02/07/2014
02/07/2014
02/18/2014 04/22/2014
04/22/2014 04/24/2014 04/24/2014

Service, Inc., Patterson District Ambulance, Piner's Ambulance, Inc., Progressive Ambulance, Inc., Regional Emergency Medical Services Authority, Riggs Ambulance Service, Inc., San Luis Ambulance Service, Inc., Schaefer Ambulance Service, Inc., Sierra Ambulance Service, Inc., Sierra Lifestar, Inc., Sierra Medical Services Alliance, Westmed Ambulance, Inc.. (Hagemann, Kelly) (Entered: 01/24/2014)
105 MINUTE ORDER IN CHAMBERS by Judge Christina A. Snyder: Status Conference set for 2/7/2014 11:00 AM before Judge Christina A. Snyder. (rne) (Entered: 01/30/2014)
106 AMENDED MINUTE ORDER IN CHAMBERS by Judge Christina A. Snyder: re: Minutes of In Chambers Order 105 . (rne) (Entered: 01/30/2014)
107 REQUEST for Leave to Defendants' Request to Appear by Telephone filed by Defendants California Department of Health Care Services, Toby Douglas. Request set for hearing on 2/7/2014 at 11:00 AM before Judge Christina A. Snyder. (Attachments: # 1 Proposed Order)(Stanton, Hadara) (Entered: 01/30/2014)
108 ORDER GRANTING DEFENDANT'S REQUEST TO APPEAR BY TELEPHONE AT THE 2/7/2014 STATUS CONFERENCE by Judge Christina A. Snyder: Defendant's request to appear by telephone at the 2/7/2014, Status Conference 107 is hereby granted. The Court shall contact Defendant's counsel at 11:00 AM for the Status Conference on 2/7/2014. (gk) (Entered: 02/03/2014)
109 MINUTES OF Status Conference held before Judge Christina A. Snyder: The Court confers with counsel. The Court grants the request to reopen discovery. The Court schedules the following dates: Discovery cut−off 5/7/2014. Plaintiffs' Opposition to defendants' Motion for Summary Judgment Deadline 6/6/2014. Hearing on Defendants' Motion for Summary Judgment 95 on 6/28/2014 at 10:00 AM before Judge Christina A. Snyder. (Case reopened. MD JS−5.) Court Reporter: Laura Elias. (gk) (Entered: 02/10/2014)
111 AMENDED MINUTES OF Status Conference Re Case 109 held before Judge Christina A. Snyder: The Court confers with counsel. The Court grants the request to reopen discovery. The Court schedules the following dates: Discovery cut−off 5/7/2014. Plaintiffs' Opposition to defendants' Motion for Summary Judgment Deadline 6/6/2014. Hearing on Defendants' Motion for Summary Judgment 95 on 7/28/2014 at 10:00 AM before Judge Christina A. Snyder. Court Reporter: Laura Elias. (gk) (Entered: 02/20/2014)
110 DISCLOSURE of Defendant's Supplemental Rule 26 Disclosures filed by Defendants California Department of Health Care Services, Toby Douglas (Stanton, Hadara) (Entered: 02/18/2014)
112 EX PARTE APPLICATION for Order for Protective Order or Alternatively for An Order Shortening Time on Defendant's Motion for Protective Order filed by Defendant California Department of Health Care Services, Toby Douglas. (Attachments: # 1 Memorandum Memorandum of Points and Authorities In Support of Ex Parte Application, # 2 Declaration Declaration of Hadara R. Stanton In Support for Protective Order, # 3 Exhibit 1, # 4 Exhibit 2, # 5 Exhibit 3, # 6 Exhibit 4, # 7 Exhibit 5, # 8 Proposed Order [Proposed] Order, # 9 Declaration Declaration of Service)(Stanton, Hadara) (Entered: 04/22/2014)
113 NOTICE by Magistrate Judge Margaret A. Nagle requiring any opposition to Defendant's Ex Parte Application for Order for Protective Order 112 to be filed by no later than 11:00 AM on 4/24/2014. THERE IS NO PDF DOCUMENT ASSOCIATED WITH THIS ENTRY. (ec) TEXT ONLY ENTRY (Entered: 04/22/2014)
114 Opposition re: EX PARTE APPLICATION for Order for Protective Order or Alternatively for An Order Shortening Time on Defendant's Motion for Protective Order 112 filed by Plaintiff Sierra Medical Services Alliance. (Attachments: # 1 Declaration of Kelly M. Hagemann, # 2 Proposed Order)(Hagemann, Kelly) (Entered: 04/24/2014)
115 NOTICE by Magistrate Judge Margaret A. Nagle scheduling hearing re: Defendants' Ex Parte Application 112 for hearing on 4/25/2014 at 11:30 AM before Magistrate Judge Margaret A. Nagle. THERE IS NO PDF DOCUMENT ASSOCIATED WITH

Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 30 of 33

04/25/2014 04/30/2014 05/07/2014 06/06/2014
06/06/2014
06/06/2014

THIS ENTRY. (ec) TEXT ONLY ENTRY (Entered: 04/24/2014)
116 MINUTES OF Discovery Hearing held before Magistrate Judge Margaret A. Nagle: denying 112 Ex Parte Application for Protective Order. (See order for details) Court Recorder: CS. (ec) (Entered: 04/25/2014)
117 STIPULATION for Protective Order filed by Plaintiff Sierra Ambulance Service, Inc.. (Attachments: # 1 Proposed Order)(Hagemann, Kelly) (Entered: 04/30/2014)
118 MINUTES OF TELEPHONE CONFERENCE RE DEPOSITIONS held before Magistrate Judge Margaret A. Nagle. A telephonic conference regarding depositions was held off the record. (mz) (Entered: 05/07/2014)
119 MEMORANDUM in Opposition to MOTION for Summary Judgment Memorandum of Points and Authorities In Support 95 filed by Plaintiffs American Ambulance of Visalia, American Legion Post 108 Ambulance Service, California Ambulance Association, Care Ambulance Service, Inc., Care Flight, City Ambulance of Eureka, Inc., Community Ambulance Services, Inc., Del Norte Ambulance, Inc., Delano Ambulance Service, Inc., Desert Ambulance Service, Exeter District Ambulance, First Responder Emergency Medical Services, Inc., First Responder Emergency Medical Services−Sacramento, Inc., Hall Ambulance Service, Inc., Imperial Ambulance Services, Inc., K.W.P.H. Enterprises, Kern Emergency Medical Transportation Corporation, Manteca District Volunteer Ambulance Service, Metro West Ambulance Service, Inc., Patterson District Ambulance, Piner's Ambulance, Inc., Progressive Ambulance, Inc., Regional Emergency Medical Services Authority, Riggs Ambulance Service, Inc., San Luis Ambulance Service, Inc., Schaefer Ambulance Service, Inc., Sierra Ambulance Service, Inc., Sierra Lifestar, Inc., Sierra Medical Services Alliance, Westmed Ambulance, Inc.. (Attachments: # 1 Declaration Declaration Of Kelly M. Hagemann In Support Of Opposition To Defendants Motion For Summary Judgment, # 2 Declaration Declaration Of Brenda Staffan In Support Of Opposition To Motion For Summary Judgment, # 3 Declaration Declaration Of Henry W. Zaretsky In Support Of Plaintiffs Opposition To Motion For Summary Judgment)(Hagemann, Kelly) (Entered: 06/06/2014)
120 STATEMENT of Plaintiffs Statement Of Genuine Disputes Of Material Facts In Opposition To Defendants Motion For Summary Judgment MOTION for Summary Judgment Memorandum of Points and Authorities In Support 95 filed by Plaintiffs American Ambulance of Visalia, American Legion Post 108 Ambulance Service, California Ambulance Association, Care Ambulance Service, Inc., Care Flight, City Ambulance of Eureka, Inc., Community Ambulance Services, Inc., Del Norte Ambulance, Inc., Delano Ambulance Service, Inc., Desert Ambulance Service, Exeter District Ambulance, First Responder Emergency Medical Services, Inc., First Responder Emergency Medical Services−Sacramento, Inc., Hall Ambulance Service, Inc., Imperial Ambulance Services, Inc., K.W.P.H. Enterprises, Kern Emergency Medical Transportation Corporation, Manteca District Volunteer Ambulance Service, Metro West Ambulance Service, Inc., Patterson District Ambulance, Piner's Ambulance, Inc., Progressive Ambulance, Inc., Regional Emergency Medical Services Authority, Riggs Ambulance Service, Inc., San Luis Ambulance Service, Inc., Schaefer Ambulance Service, Inc., Sierra Ambulance Service, Inc., Sierra Lifestar, Inc., Sierra Medical Services Alliance, Westmed Ambulance, Inc.. (Attachments: # 1 Proposed Order [Proposed] Order Denying Defendants Motion For Summary Judgment)(Hagemann, Kelly) (Entered: 06/06/2014)
121 Plaintiffs Objections To Evidence In Opposition To Defendants Motion For Summary Judgment In Support of Opposition re: MOTION for Summary Judgment Memorandum of Points and Authorities In Support 95 filed by Plaintiffs American Ambulance of Visalia, American Legion Post 108 Ambulance Service, California Ambulance Association, Care Ambulance Service, Inc., Care Flight, City Ambulance of Eureka, Inc., Community Ambulance Services, Inc., Del Norte Ambulance, Inc., Delano Ambulance Service, Inc., Desert Ambulance Service, Exeter District Ambulance, First Responder Emergency Medical Services, Inc., First Responder Emergency Medical Services−Sacramento, Inc., Hall Ambulance Service, Inc., Imperial Ambulance Services, Inc., K.W.P.H. Enterprises, Kern Emergency Medical Transportation Corporation, Manteca District Volunteer Ambulance Service, Metro West Ambulance Service, Inc., Patterson District Ambulance, Piner's Ambulance, Inc., Progressive Ambulance, Inc., Regional Emergency Medical Services Authority, Riggs

Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 31 of 33

06/27/2014 07/11/2014 07/11/2014 07/18/2014 07/21/2014
07/28/2014 08/07/2014 08/11/2014 08/22/2014
09/08/2014 09/08/2014 09/10/2014

Ambulance Service, Inc., San Luis Ambulance Service, Inc., Schaefer Ambulance Service, Inc., Sierra Ambulance Service, Inc., Sierra Lifestar, Inc., Sierra Medical Services Alliance, Westmed Ambulance, Inc.. (Hagemann, Kelly) (Entered: 06/06/2014)
122 PROTECTIVE ORDER by Magistrate Judge Margaret A. Nagle re Stipulation for Protective Order 117 (ec) (Entered: 06/27/2014)
123 REPLY Defendant's Reply to Plaintiffs' Opposition to Defendant's Motion for Summary Judgment MOTION for Summary Judgment Memorandum of Points and Authorities In Support 95 filed by Defendant California Department of Health Care Services. (Stanton, Hadara) (Entered: 07/11/2014)
124 Defendant's Objections to Plaintiffs' Evidence in Support of Opposition to Defendant's Motion for Summary Judgment Opposition re: MOTION for Summary Judgment Memorandum of Points and Authorities In Support 95 filed by Defendant California Department of Health Care Services. (Stanton, Hadara) (Entered: 07/11/2014)
125 STIPULATION to Dismiss Plaintiff Manteca District Volunteer Ambulance Service filed by Plaintiff Manteca District Volunteer Ambulance Service. (Attachments: # 1 Proposed Order Proposed Order)(Hagemann, Kelly) (Entered: 07/18/2014)
126 ORDER GRANTING JOINT STIPULATION TO DISMISS MANTECA DISTRICT VOLUNTEER AMBULANCE SERVICE'S dba MANTECA DISTRICT AMBULANCE SERVICE CLAIMS AGAINST TOBY DOUGLAS by Judge Christina A. Snyder: Upon Stipulation 125 , IT IS HEREBY ORDERED that all claims Manteca District Volunteer Ambulance Service, dba Manteca District Ambulance Service asserted against Defendant Toby Douglas are hereby dismissed with prejudice. (gk) (Entered: 07/23/2014)
127 MINUTES OF Motion Hearing held before Judge Christina A. Snyder: Defendants' Motion for Summary Judgment 95 is hereby GRANTED. Court Reporter: Laura Elias. (gk) (Entered: 07/29/2014)
128 NOTICE filed by Defendant Toby Douglas. / Notice of Lodging of Proposed Judgment (Attachments: # 1 Proposed Order [PROPOSED] JUDGMENT FOR DEFENDANT)(Stanton, Hadara) (Entered: 08/07/2014)
129 JUDGMENT FOR DEFENDANT by Judge Christina A. Snyder. Pursuant to the Court's 7/28/2014 Order Granting Defendant's Motion for Summary Judgment 127 , it is hereby ordered that JUDGMENT shall be entered in favor of Defendants as prevailing parties and against Plaintiffs. Costs shall be taxedagainst Plaintiffs. (MD JS−6, Case Terminated). (jp) (Entered: 08/13/2014)
130 APPLICATION to the Clerk to Tax Costs against Plaintiff All Plaintiffs re: Judgment, 129 , filed by Defendant Toby Douglas. Application set for hearing on 9/11/2014 at 11:00 AM before Judge Christina A. Snyder. (Attachments: # 1 Declaration DECLARATION OF DEPUTY ATTORNEY GENERAL HADARA R. STANTON IN SUPPORT OF THE APPLICATION TO THE CLERK TO TAX COSTS AND PROPOSED BILL OF COSTS, # 2 Declaration DECLARATION OF NORA LYMAN IN SUPPORT OF THE APPLICATION TO THE CLERK TO TAX COSTS AND PROPOSED BILL OF COSTS)(Stanton, Hadara) (Entered: 08/22/2014)
131 BILL OF COSTS Deficiency Notice Filed. The following deficiency was noted on Defendant Toby Douglas's Notice of Application to the Clerk to Tax Costs 130 : L.R. 54−2.2 Hearing should be noticed before the clerk's designee and not the judge. Counsel is to re−notice the corrected hearing information. (gk) (Entered: 09/08/2014)
132 NOTICE OF MOTION re APPLICATION to the Clerk to Tax Costs against Plaintiff All Plaintiffs re: Judgment, 129 , 130 filed by Defendant California Department of Health Care Services. Motion set for hearing on 9/11/2014 at 11:00 AM before Clerk of Court. (Attachments: # 1 Declaration, # 2 Declaration)(Stanton, Hadara) (Entered: 09/08/2014)
133 NOTICE OF APPEAL to the 9th CCA filed by Plaintiffs American Ambulance of Visalia, American Legion Post 108 Ambulance Service, California Ambulance Association, Care Ambulance Service, Inc., Care Flight, City Ambulance of Eureka, Inc., Community Ambulance Services, Inc., Del Norte Ambulance, Inc., Delano

Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 32 of 33

09/10/2014 09/10/2014
09/11/2014 09/25/2014
02/03/2015 02/03/2015

Ambulance Service, Inc., Desert Ambulance Service, Exeter District Ambulance, First Responder Emergency Medical Services, Inc., First Responder Emergency Medical Services−Sacramento, Inc., Hall Ambulance Service, Inc., Imperial Ambulance Services, Inc., K.W.P.H. Enterprises, Kern Emergency Medical Transportation Corporation, Metro West Ambulance Service, Inc., Patterson District Ambulance, Piner's Ambulance, Inc., Progressive Ambulance, Inc., Regional Emergency Medical Services Authority, Riggs Ambulance Service, Inc., San Luis Ambulance Service, Inc., Schaefer Ambulance Service, Inc., Sierra Ambulance Service, Inc., Sierra Lifestar, Inc., Sierra Medical Services Alliance, Westmed Ambulance, Inc.. Appeal of Judgment, 129 (Appeal fee of $505 receipt number 0973−14427452 paid.) (Warren, Kevin) (Entered: 09/10/2014)
134 REPRESENTATION STATEMENT re Notice of Appeal to 9th Circuit Court of Appeals,,,, 133 . (Warren, Kevin) (Entered: 09/10/2014)
135 NOTIFICATION by Circuit Court of Appellate Docket Number 14−56483, 9th CCA regarding Notice of Appeal to 9th Circuit Court of Appeals 133 as to Plaintiffs American Ambulance of Visalia, American Legion Post 108 Ambulance Service, California Ambulance Association, Care Ambulance Service, Inc., Care Flight, City Ambulance of Eureka, Inc., Community Ambulance Services, Inc., Del Norte Ambulance, Inc., Delano Ambulance Service, Inc., Desert Ambulance Service, Exeter District Ambulance, First Responder Emergency Medical Services, Inc., First Responder Emergency Medical Services−Sacramento, Inc., Hall Ambulance Service, Inc., Imperial Ambulance Services, Inc., K.W.P.H. Enterprises, Kern Emergency Medical Transportation Corporation, Manteca District Volunteer Ambulance Service, Metro West Ambulance Service, Inc., Patterson District Ambulance, Piner's Ambulance, Inc., Progressive Ambulance, Inc., Regional Emergency Medical Services Authority, Riggs Ambulance Service, Inc., San Luis Ambulance Service, Inc., Schaefer Ambulance Service, Inc., Sierra Ambulance Service, Inc., Sierra Lifestar, Inc., Sierra Medical Services Alliance, Westmed Ambulance, Inc. (dmap) (Entered: 09/11/2014)
136 BILL OF COSTS. Costs Taxed in amount of $ 2729.20 in favor of Defendant and against Plaintiff. RE: 129 , 130 (mb) (Entered: 09/25/2014)
137 TRANSCRIPT ORDER as to Plaintiffs American Ambulance of Visalia, American Legion Post 108 Ambulance Service, California Ambulance Association, Care Ambulance Service, Inc., Care Flight, City Ambulance of Eureka, Inc., Community Ambulance Services, Inc., Del Norte Ambulance, Inc., Delano Ambulance Service, Inc., Desert Ambulance Service, Exeter District Ambulance, First Responder Emergency Medical Services, Inc., First Responder Emergency Medical Services−Sacramento, Inc., Hall Ambulance Service, Inc., Imperial Ambulance Services, Inc., K.W.P.H. Enterprises, Kern Emergency Medical Transportation Corporation, Metro West Ambulance Service, Inc., Patterson District Ambulance, Piner's Ambulance, Inc., Progressive Ambulance, Inc., Regional Emergency Medical Services Authority, Riggs Ambulance Service, Inc., San Luis Ambulance Service, Inc., Schaefer Ambulance Service, Inc., Sierra Ambulance Service, Inc., Sierra Lifestar, Inc., Sierra Medical Services Alliance, Westmed Ambulance, Inc. Court Reporter. Court will contact Susan Totin at stotin@mrllp.com with any questions regarding this order. Transcript portion requested: Other: July 28, 2014. Transcript preparation will not begin until payment has been satisfied with the court reporter/recorder. (Warren, Kevin) (Entered: 09/25/2014)
138 TRANSCRIPT for proceedings held on 07−28−14. Court Reporter/Electronic Court Recorder: Laura Elias, phone number 213−620−0890. Transcript may be viewed at the court public terminal or purchased through the Court Reporter/Electronic Court Recorder before the deadline for Release of Transcript Restriction. After that date it may be obtained through PACER. Notice of Intent to Redact due within 7 days of this date. Redaction Request due 2/24/2015. Redacted Transcript Deadline set for 3/6/2015. Release of Transcript Restriction set for 5/4/2015. (Elias, Laura) (Entered: 02/03/2015)
139 NOTICE OF FILING TRANSCRIPT filed for proceedings 07−28−14 re Transcript 138 THERE IS NO PDF DOCUMENT ASSOCIATED WITH THIS ENTRY. (Elias, Laura) TEXT ONLY ENTRY (Entered: 02/03/2015)

Case: 2:10-cv-4182 As of: 11/08/2017 01:28 PM PST 33 of 33

03/13/2015
03/13/2015 06/10/2015

140 TRANSCRIPT for proceedings held on December 10, 2012 at 10:05 a.m.. Court Reporter/Electronic Court Recorder: Laura Elias, phone number 213−620−0890. Transcript may be viewed at the court public terminal or purchased through the Court Reporter/Electronic Court Recorder before the deadline for Release of Transcript Restriction. After that date it may be obtained through PACER. Notice of Intent to Redact due within 7 days of this date. Redaction Request due 4/3/2015. Redacted Transcript Deadline set for 4/13/2015. Release of Transcript Restriction set for 6/11/2015. (Elias, Laura) (Entered: 03/13/2015)
141 NOTICE OF FILING TRANSCRIPT filed for proceedings December 10, 2012 at 10:05 a.m. re Transcript 140 THERE IS NO PDF DOCUMENT ASSOCIATED WITH THIS ENTRY. (Elias, Laura) TEXT ONLY ENTRY (Entered: 03/13/2015)
142 ORDER from Ninth Circuit Court of Appeals filed re: Notice of Appeal to 9th Circuit Court of Appeals 133 filed by Sierra Lifestar, Inc., et al., CCA # 14−56483. The motion to voluntarily dismiss this appeal filed by appellants Manteca District Volunteer Ambulance Service ("Manteca") and Exeter District Ambulance ("Exeter") is granted. All appellants other then Manteca and Exeter, and the appellee remainparties to this pending appeal.A copy of this order shall serve as and for the mandate of this court. (mat) (Entered: 06/15/2015)