Court Opinion

ID: 9554178
Source: CourtListenerOpinion
Date Created: 2023-08-07 22:05:19.729789+00
Date Added: 2024-06-11T15:33:25.254609
License: Public Domain

Filed 8/7/23

                            CERTIFIED FOR PUBLICATION

               IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA

                             FOURTH APPELLATE DISTRICT

                                       DIVISION THREE

 GENE MORAN,

      Plaintiff and Appellant,                      G060920

          v.                                        (Super. Ct. No. 30-2013-00689394)

 PRIME HEALTHCARE                                   OPINION
 MANAGEMENT, INC., et al.,

      Defendants and Respondents.

                 Appeal from an order of the Superior Court of Orange County, Glenda
Sanders, Judge. Affirmed. Request for judicial notice granted.
                 Carpenter Law, Gretchen Carpenter; Law Office of Barry Kramer and
Barry L. Kramer for Plaintiff and Appellant.
                 Miller Barondess, Mira Hashmall and Adam M. Agatston for Defendants
and Respondents.
                                   *         *          *
                This is the second appeal in this putative class action regarding hospital
fees and costs for patients not covered by insurance. Plaintiff Gene Moran, who was a
patient at Huntington Beach Hospital (the Hospital) three times in 2013, sued defendants
Prime Healthcare Management, Inc., Prime Healthcare Huntington Beach, LLC, Prime
Healthcare Services, Inc., and Prime Healthcare Foundation, Inc. (collectively
defendants) under various theories in 2013. In our prior opinion, we found that while
            1

most of Moran’s claims lacked merit, he had sufficiently alleged facts supporting
standing to claim the amount that self-pay patients were charged was unconscionable,
and we reversed the trial court’s dismissal of the case. (Moran v. Prime Healthcare
Management, Inc. (2016) 3 Cal.App.5th 1131, 1137 (Moran).)

                Moran’s sixth amended complaint included both the allegations regarding
unconscionability and a new theory of the case. The new allegations asserted defendants
had violated the Unfair Competition Law (UCL; Bus. & Prof. Code, § 17200), and the
Consumer Legal Remedies Act (CLRA; Civ. Code, § 1750 et seq.) by failing to disclose
Evaluation and Management (EMS) fees charged in the emergency room through signage
or other methods. The complaint sought relief under both the old and new theories for
violations of the UCL, CLRA, and for declaratory relief (Code Civ. Proc., § 1060).
                Defendants moved to strike the allegations regarding EMS fees, arguing
their disclosure obligations were defined by statute. The trial court agreed and struck the
allegations from the sixth amended complaint.
                We conclude that the trial court’s order striking the EMS fee allegations
was proper. The duties Moran seeks to impose on defendants interfere with the extensive

 According to the sixth amended complaint, “Defendants Prime Healthcare Services,
1

Inc., and/or Prime Healthcare Services Foundation, Inc., together own and/or operate one
or more medical care facilities throughout California, including Huntington Beach
Hospital, and that Defendant Prime Healthcare Management, Inc. provides management
and billing services for these Hospitals.”

                                               2
and carefully drawn state and federal legislative and regulatory scheme governing the
disclosure and transparency of hospital prices. Accordingly, we affirm the order.

                                                I
                                            FACTS

Background
              As our prior opinion stated, “On three occasions in October 2013, plaintiff,
‘a self-pay patient,’ went to the emergency room of a hospital owned and operated by
defendants . . . . Each time, he signed a printed Conditions of Admission agreement
(Contract) and received medical treatment. Subsequently, plaintiff received bills from
the hospital for the treatment provided during the three visits that exceeded $10,000.
              “In November 2013, plaintiff filed this putative class action against
defendants. The initial complaint stated causes of action for breach of contract, breach of
the implied covenant of good faith and fair dealing, violation of the UCL, restitutionary
relief under the CLRA, and declaratory relief. Plaintiff subsequently dropped the first
and second counts. His first amended complaint also expanded the scope of the CLRA
cause of action to include a request for damages by alleging that he complied with the
statutory requirement of giving defendants notice of the purportedly unlawful practice
and a demand for correction of it. Although verbose, confusing, containing contradictory
allegations, and contentions of law, each iteration of the complaint is based on allegations
the rates defendants charge self-pay patients are discriminatory, exceed the reasonable
value of the treatment, and are ‘artificially inflated and grossly excessive.’” (Moran,
supra, 3 Cal.App.5th at pp. 1137-1138.) In July 2014, the Hospital sent a letter to Moran
stating that following an administrative review, his accounts had been settled and he had
a zero balance. The Hospital also contacted the credit reporting agencies to inform them
that any information regarding the Hospital should be removed, and issued Moran a
partial refund of $50 for one of his visits. (Id. at p. 1137, fn. 1.)

                                                3
              Defendants demurred to the third amended complaint, which the trial court
sustained without leave to amend. (Moran, supra, 3 Cal.App.5th at p. 1138.) We found
that while Moran had standing and had sufficiently alleged the Contract was
unconscionable, the remainder of his other claims were invalid. (See id. at pp. 1141-
1153.)
              After remand, Moran filed a fourth and eventually a fifth amended
complaint. The fifth amended complaint alleged representative claims with respect to the
UCL and CLRA causes of action, and a class claim as to the declaratory relief cause of
action. His list of common questions of law and fact in the declaratory relief cause of
action related to the reasonableness and/or unconscionability of the rates charged despite
contractual language promising to pay. Around the same time, however, a number of
trial courts had declined to certify classes based on the same theory, and Division One of
this District had affirmed the denials. (See, e.g., Hefczyc v. Rady Children’s Hosp.-San
Diego (2017) 17 Cal.App.5th 518, disapproved of in part by Noel v. Thrifty Payless, Inc.
(2019) 7 Cal.5th 955, 986, fn. 15; Kendall v. Scripps Health (2017) 16 Cal.App.5th 553,
disapproved of in part by Noel, at p. 986, fn. 15.)
                                                      2

              Following these decisions, Moran later moved to certify a class on a
different basis. His proposed “issue” class was based on the question of whether the
Hospital had a duty to disclose EMS fees, a subject which had not been raised in any of
his six prior complaints. The court noted, in denying the motion for class certification,
that this class was “quite different from that alleged in [Moran’s] Fifth Amended

 In Noel v. Thrifty Payless, Inc., supra, 7 Cal.5th at pages 985-986, the California
2

Supreme Court disapproved a line of cases which had reasoned that a proposed class
must be ascertainable without unreasonable expense or time. In addition to finding the
class was not ascertainable, the court in Hefczyc v. Rady Children’s Hosp.-San Diego,
supra, 17 Cal.App.5th at pages 540-545, also found that common issues did not
predominate and that class treatment was not superior to other forms of litigation.
In Kendall v. Scripps Health, supra, 16 Cal.App.5th at pages 564-574, the court had also
found that common issues did not predominate.

                                              4
Complaint.” The court ultimately denied the motion to certify the class and granted leave
to file a sixth amended complaint, which is the operative complaint before us.

Sixth Amended Complaint
               In the sixth amended complaint, filed on March 8, 2021, Moran stated he
                                                                        3

challenged “two specific practices of Defendants. First, on a classwide basis, Plaintiff
challenges Defendants’ unfair, deceptive, and unlawful practice of charging emergency
room patients an ‘Evaluation and Management Services Fee’ or ‘EMS Fee,’ without any
notification of their intention to charge a prospective emergency room patient such a Fee
for the patient’s emergency room visit . . . and without any agreement by Plaintiff to pay
for such a Fee.” This is the claim, new to the sixth amended complaint, that is at issue in
                                                                            4

this appeal.
               Under general allegations concerning the EMS fee, Moran alleged that
charging this fee “without any notification of their intention to charge a prospective
emergency room patient such a Fee for the patient’s emergency room visit” was an
“unfair, deceptive, and unlawful practice.” The issue, according to the complaint, “is not
that Defendants fail to list an EMS Fee as a line item in the Hospital’s published
Chargemaster,[ ] or that Defendants fail to list the price of such EMS Fees in the
               5

 The original complaint was filed on November 25, 2013. This case has been pending
3

for over nine years without moving beyond the pleading stage.

 From this point forward, we refer to the sixth amended complaint as “the complaint”
4

unless it is necessary to distinguish it from an earlier version.

 “The chargemaster lists the uniform charge for given services represented by the
5

hospital as its gross billed charge for a given service or item, regardless of payer type,
and sets forth every hospital charge for every type of service, including emergency room
services.” (Gray v. Dignity Health (2021) 70 Cal.App.5th 225, 230 (Gray).) The
complaint alleged, on information and belief, that the Hospital “does not make its
Chargemaster spreadsheet reasonably available to emergency room patients at the time of
their emergency room visits.”

                                             5
Hospital’s Chargemaster, but rather the fact that Defendants give no notification or
warning that they charge an EMS Fee for an emergency room visit. As a result,
emergency room patients end up being surprised by a substantial charge added to their
bill that they were not expecting. Such charges are effectively hidden by Defendants’
intentional failure to provide notice of them in the emergency room.”
                  Further, the complaint alleged that the EMS fee is charged “simply for
seeking treatment in the emergency room; it is independent of, and in addition to, the
charges for the individual items of treatment and services provided to a patient. Rather
than being tied to the individual items of treatment and services a patient receives in the
emergency room, an EMS Fee is charged to all patients who receive treatment in the
emergency room, regardless of what other services and treatment they receive. This
Evaluation and Management Services Fee invariably comes as a complete surprise to
unsuspecting emergency room patients.” The EMS fee, Moran alleged, is charged at one
of five levels.
                  Defendants, Moran alleged, keep this fee “effectively hidden from patients
who might otherwise look for less costly medical treatment and services elsewhere, such
as in urgent care facilities that do not charge such fees, or even forego treatment
altogether.” The EMS fee “is not visibly posted on signage in or around Hospital’s
emergency rooms or on signage at its registration windows/desks, where a patient would
at least have the opportunity of knowing of its existence, nor is it disclosed to patients
orally at the time of registration, or by any other means.” Nor, the complaint alleged, is
the EMS fee disclosed in writing, either before admission or at the time of discharge.
The complaint alleged the chargemaster did not list the EMS fee as being charged to all
emergency room patients, although the chargemasters themselves reveal EMS fees for
levels two through four are listed under the 25 most common procedures, with language
such as “Emergency Room Visit, Level 2 (low to moderate severity)” in both the 2012

                                                6
and 2020 chargemasters. With respect to his own claim, Moran alleged he was charged
                          6

a total of $3,568.80 in EMS fees over three visits. In sum, the failure to disclose the EMS
fee, the complaint alleged, violated the UCL, CLRA, and was subject to declaratory
relief.
              Defendants moved to strike the EMS fee claims, arguing that no duty to
disclose EMS fees existed outside the context of the requirements set forth in the relevant
provisions of the Health and Safety Code. Moran opposed. The court issued a tentative
                                           7

ruling stating that the Hospital had established compliance with the relevant provisions of
state law. Citing Nolte v. Cedars-Sinai Medical Center (2015) 236 Cal.App.4th 1401
(Nolte), the court held that such compliance satisfied the requirements of the UCL. As to
the CLRA, the tentative stated that the allegations regarding lack of notice did not fall
within the relevant provisions of the statute. The tentative also struck the declaratory
judgment allegations.
              After a hearing and supplemental briefing, the trial court issued its ruling
granting the Hospital’s motion to strike. This appeal followed.

 The court took judicial notice of the chargemasters, a ruling that Moran does not contest
6

on appeal. EMS fees have the requisite codes, often referred to as billing codes, but
technically called “Current Procedural Terminology” or CPT codes, promulgated by the
American Medical Association. Federal regulations for Medicare-participating hospitals
require hospitals to bill emergency room visits for Medicare using the five-tiered system
for EMS fees. (See 72 Fed.Reg. 66580-01 (Nov. 27, 2007); 80 Fed.Reg. 70298-01,
70448 (Nov. 13, 2015).) Accordingly, the amount of an EMS fee changes with the
severity of a patient’s condition and the resources required to evaluate and manage their
care. (See Ibid.)

 Subsequent statutory references are to the Health and Safety Code unless otherwise
7

indicated.

                                               7
                                              II
                                       DISCUSSION
              Both parties agree that this case is appealable under the “death knell”
doctrine relating to putative class actions. (In re Baycol Cases I & II (2011) 51 Cal.4th
751, 757-759.) We agree that exercising appellate jurisdiction is appropriate in this case.

A. Standard of Review
              “Code of Civil Procedure section 436 permits a court on its own motion or
on motion by a party to ‘[s]trike out all or any part of any pleading not drawn or filed in
conformity with the laws of this state, a court rule, or an order of the court.’ [Citation.]
We review an order striking all or part of a pleading generally for abuse of discretion.
[Citations.] Under that standard, we do not disturb the trial court’s order unless a party
has shown a clear case of abuse as well as a miscarriage of justice. [Citations.]
‘“Discretion is abused whenever, in its exercise, the court exceeds the bounds of reason,
all of the circumstances before it being considered.”’ [Citation.] However, to the extent
we are required to decide whether the court properly interpreted and applied governing
law in concluding a plaintiff has failed to state a cause of action, we review the matter
independently.” (Willis v. City of Carlsbad (2020) 48 Cal.App.5th 1104, 1115.)
              We agree with Moran (the defendants do not argue otherwise) that the
questions involved here are questions of law, and accordingly, our review should be the
same as would apply if this were a general demurrer. We assume the truth of “all
material facts properly pleaded, but not contentions, deductions, or conclusions of fact or
law. We also consider matters which may be judicially noticed.” (McBride v. Boughton
(2004) 123 Cal.App.4th 379, 384-385.)

                                              8
B. Propriety of a Motion to Strike
              Moran argues that “[a] motion to strike was not the proper vehicle for the
relief Hospital sought.” He argues that a motion for summary adjudication was the
appropriate procedure. In offering this argument, Moran seeks to have it both ways –
contending that we should apply de novo review and treat defendants’ motion to strike as
a general demurrer to the specific allegations when it suits him, and claiming that failure
to state a cause of action is not an appropriate ground for a motion to strike.
              To the extent we treat this case, as Moran explicitly requested, under the
same standard of review as a demurrer, we find no error. Moran chose to combine his
two theories of liability, unconscionability and failure to disclose the EMS fees, in a
single cause of action. Accordingly, a demurrer cannot lie. (Daniels v. Select Portfolio
Servicing, Inc. (2016) 246 Cal.App.4th 1150, 1167.)
              We find this case easily falls within the purview of PH II, Inc. v. Superior
Court (1995) 33 Cal.App.4th 1680, and its progeny, which allows a court to strike a
defective portion of a cause of action. “We recognize that in some cases a portion of a
cause of action will be substantively defective on the face of the complaint. Although a
defendant may not demur to that portion, in such cases, the defendant should not have to
suffer discovery and navigate the often dense thicket of proceedings in summary
adjudication. We conclude that when a substantive defect is clear from the face of a
complaint, such as . . . a purported claim of right which is legally invalid, a defendant
may attack that portion of the cause of action by filing a motion to strike.” (Id. at pp.
1682-1683.)
              There is no need for an expensive motion for summary adjudication to add
to what must already be the high costs of this almost 10-year-old case. The purported
defects are clear from the face of the complaint, and therefore, a motion to strike was
proper. Moreover, Moran claims no procedural unfairness as a result of the use of the
motion to strike, such as the lack of adequate time to respond. This motion was

                                              9
extensively litigated and carefully considered by the trial court, as reflected in its
tentative rulings and orders. Sending this case back for a summary adjudication motion
would only be a waste of resources for both the parties and the court.

C. The Statutory Framework
              The Payers’ Bill of Rights, effective July 1, 2004, and codified at section
1339.50, et seq., was adopted to “provide patients, health plans and health care
purchasers with more information about charges for hospital care. The author states that
this bill will also discourage hospitals from playing games with hospital pricing in a way
that gouges private payers and patients.” (Assem. Com. on Health, Rep. on Assem. Bill
No. 1627 (2003-2004 Reg. Sess.) as amended Apr. 24, 2003, p. 2.) “Supporters of this
legislation argue that it will assist consumers in making informed choices between health
providers.” (Ibid.)
              As adopted, hospitals were required to (1) “make a written or electronic
copy of its charge description master available, either by posting an electronic copy of the
charge description master on the hospital’s Internet Web site, or by making one written or
electronic copy available at the hospital location” (Assem. Bill No. 1627 (2003-2004
Reg. Sess.) as amended Sept. 2, 2003), and (2) “post a clear and conspicuous notice in its
emergency department, if any, in its admissions office, and in its billing office that
informs patients that the hospital’s charge description master is available in the manner
described in subdivision (a).” (Ibid.)
              Early versions of the bill would have required facilities that use a
chargemaster to provide written copies upon request. (Assem. Bill No. 1627 (2003-2004
Reg. Sess.) as introduced Feb. 21, 2003.) A subsequent version also required “a hospital
to post a notice, as specified, that informs patients that the hospital’ [chargemaster] is
available on request.” (Assem. Bill No. 1627 (2003-2004 Reg. Sess.) as amended Apr. 7,
2003.) These requirements were changed in the final version of the bill. Hospitals were

                                              10
required to post their chargemasters on their web sites or to make a written or electronic
copy available at the hospital itself. (§ 1339.51, subd. (a)(1).) The only signage required
was “a clear and conspicuous notice in its emergency department, if any, in its
admissions office, and in its billing office that informs patients that the hospital’s charge
description master is available” on its web site or via written or electronic copy.
(§ 1339.51, subd. (c).)
              The Payers’ Bill of Rights included other requirements in furtherance of its
goal of price transparency. As amended, hospitals were also required to file their
chargemasters annually with the Office of Statewide Health Planning and Development
(OSHPD), and to list their 25 most common outpatient procedures and the average prices
with OSHPD, which publishes that information on its web site. (§§ 1339.55, 1339.56,
subd. (a).) As noted above, the second through fourth levels EMS charges were included
in the Hospital’s list of 25 most common procedures for both 2012 and 2020.
              Additionally, at the request of a person without insurance, hospitals must
provide written estimates of expected charges, but this provision does not apply to
emergency services. (§ 1339.585.) The exception for emergency care in section
1339.585 reflects a careful balancing of transparency on the one hand and not
discouraging uninsured patients from seeking necessary emergency care on the other.
Other provisions also reflect this concern. Hospitals are not permitted, for example, to
question the patient about their ability to pay before receiving care. (§ 1317.)
              Similarly, federal law applicable to hospitals participating in Medicare,
under the Emergency Medical Treatment and Active Labor Act (EMTALA), prohibits
delaying treatment of an emergency room patient to inquire about payment or insurance
coverage. (42 U.S.C. § 1395dd(a), (h).) Federal law also requires tax-exempt hospitals
to have policies that prohibit “the hospital facility from engaging in actions that
discourage individuals from seeking emergency medical care, such as by demanding that

                                              11
emergency department patients pay before receiving treatment for emergency medical
conditions.” (26 C.F.R. § 1.501(r)–4(c)(2).)
              In the process of adopting expanded transparency regulations under the
Affordable Care Act, the Center for Medicare and Medicaid Services stated that “the
price transparency provisions . . . do not require that hospitals post any signage or make
any statement at the emergency department regarding the cost of emergency care or any
hospital policies regarding prepayment of fees or payment of co-pays and deductibles.”
(84 Fed.Reg. 65524, 65536 (Nov. 27, 2019).)
              In sum, in the emergency room context, both state and federal lawmakers
and regulators have sought a balance between transparent cost disclosure and
discouraging potentially life-threatening decisions to forego emergency treatment due to
its cost.

D. Recent Appellate Decisions
              To provide important context, we begin by discussing four recent opinions
discussing similar or identical issues, from oldest to most newest: Gray, supra, 70
Cal.App.5th 225; Torres v. Adventist Health System/West (2022) 77 Cal.App.5th 500
(Torres); Saini v. Sutter Health (2022) 80 Cal.App.5th 1054 (Saini) and Naranjo v.
Doctors Medical Center of Modesto, Inc. (2023) 90 Cal.App.5th 1193 (Naranjo) (review
granted July 26, 2023, S280374.) Before doing so, however, we must first discuss an
                                8

older case which laid some of the groundwork for the later opinions: Nolte, supra, 236
Cal.App.4th 1401.

  The California Supreme Court granted review in Naranjo days after oral argument in
8

this case. The court’s order granting review stated: “Pending review, the opinion of the
Court of Appeal . . . may be cited, not only for its persuasive value, but also for the
limited purpose of establishing the existence of a conflict in authority that would in turn
allow trial courts to exercise discretion under Auto Equity Sales, Inc. v. Superior Court
(1962) 57 Cal.2d 450, 456, to choose between sides of any such conflict.”

                                             12
              1. Nolte
              The plaintiff filed this case as a putative class action against Cedars-Sinai
Medical Center (Cedars) for charging him a one-time facility fee upon seeking treatment
from a doctor in a Cedars medical building for the first time. The plaintiff had signed a
“conditions of admission” (COA) form promising to pay Cedars for any services Cedars
provided, but the plaintiff claimed he did not know he would be charged a facility fee of
$167.01. (Nolte, supra, 236 Cal.App.4th at pp. 1404-1405.) The plaintiff sued under the
UCL and CLRA, and for unjust enrichment, restitution, and declaratory relief. The trial
court sustained Cedars’ demurrer, finding the plaintiff had obligated himself to pay the
fee by signing the COA. (Nolte, at p. 1405.)
              The appellate court affirmed. As to the UCL claim, the only one the
plaintiff did not waive on appeal (Nolte, supra, 236 Cal.App.4th at pp. 1409-1410), the
court rejected the claim that the fee was unfair and fraudulent. The fact that the law
prescribed exactly what disclosures hospitals are required to provide regarding fees and
charges was key to the court’s decision. “[H]ospitals are required by law to make
available a schedule of charges online or at the hospital, and to provide notice to
consumers (here, patients) that they have done so in a prescribed fashion, and there is no
allegation that Cedars did not do so.” (Id. at p. 1408.)
              Further, “Cedars’s agreement with Nolte’s physician was that it would set
up the computerized billing service for the patients. Nolte signed the COA stating that he
would pay Cedars’s charges, and that he may be billed separately by his physician and by
Cedars (which was prohibited by law from employing his physician). Cedars then issued
a separate bill to Nolte for creating his patient account (a function which the complaint
alleges is often provided by the medical providers themselves, who would then
presumably pass on the administrative cost to the patient). Here, Nolte agreed in the
COA to separate billing.” (Nolte, supra, 236 Cal.App.4th at p. 1408.) The court also
rejected any claim of fraud for failure to disclose. “Nolte’s allegation that Cedars did not

                                             13
separately and specifically disclose and explain the facilities fee to him is not sufficient to
state a claim that the public was likely to be deceived.” (Id. at p. 1409.)

              2. Gray
              Gray is the first case that directly addressed the claims at issue here. The
plaintiff in Gray received emergency medical care at a Dignity Health hospital, St.
Mary’s Medical Center (St. Mary’s). He alleged violations of the UCL and CLRA and
sought declaratory and injunctive relief because St. Mary’s did not post signage or
verbally tell patients during emergency room registration about an “ER Charge,” which,
as far as we can tell, is substantially identical to the EMS charge at issue here. (Gray,
supra, 70 Cal.App.5th at pp. 228-229.) The plaintiff did not allege that St. Mary’s failed
to comply with its statutory duties. Rather, the complaint alleged St. Mary’s was
required to do more than state and federal law required by disclosing to emergency room
patients, prior to providing any treatment, that its billing will include an ER charge. This
was the sole factual basis for the plaintiff’s complaint. (Id. at pp. 234-235.) Relying
largely on Nolte, the trial court sustained St. Mary’s demurrer without leave to amend.
              The appellate court affirmed. (Gray, supra, 70 Cal.App.5th at p. 229.) The
court provided a lengthy history of the Payer’s Bill of Rights and related federal law. As
                                                                9

 Moran filed a request for judicial notice of Assembly Bill No. 1045 (2005-2006
9

Reg.Sess.), introduced February 22, 2005, which proposed adding section 1339.585 to
the Payer’s Bill of Rights. The stated purpose of this request was disputing the court’s
interpretation of that history in Gray, supra, 70 Cal.App.5th at page 231.
       Assembly Bill No. 1045 (2005-2006 Reg.Sess.), as initially proposed, stated:
“Upon admission of a patient and at the patient’s request, the hospital shall provide a
written estimate of the hospital’s charges for the care that the patient is expected to
receive.” The enacted version dropped the “upon admission of a patient” language and
also explicitly excluded emergency room services. (Stats. 2005, ch. 532, § 3.)
       Gray stated that the initial version of section 1339.585 included emergency room
patients and was later amended to exclude them. (Gray, supra, 70 Cal.App.5th at p. 231.)
Moran contends, without citation to any authority, that “upon admission” does not
include admission to an emergency room, and therefore that statement in Gray is
“wrong.”

                                              14
in Nolte, the plaintiff in Gray did not allege a violation of state or federal statutory duties
regarding cost disclosures. “Rather, he claims the hospital is required to do more than is
required by the federal and state regulatory schemes, and specifically, is required to
disclose to emergency department patients, prior to providing any treatment, that its
billing will include an ER Charge (which in the case of St. Mary, is a charge set forth in
both its chargemaster and its separate list of the 25 most common outpatient charges filed
with the OSHPD).” (Id. at p. 234.) The plaintiff alleged the documents he signed upon
admission did not disclose the ER charge, nor was the charge “‘disclosed on signage
posted in or around Defendant’s emergency rooms, or verbally during the patients’
registration process.’” (Id. at p. 235.)
              As the basis for his UCL claim, the plaintiff alleged failing to disclose the
ER charge was “unfair” and “unlawful” because of the lack of signage or verbal mention
of the charge. He also alleged St. Mary’s “failure to disclose, prior to providing
emergency medical services, that its bill for such service would include an ER Charge is
both an ‘unfair’ and ‘unlawful’ business practice because the hospital ‘bills patients
amounts in violation of the [CLRA]’ and therefore his UCL ‘claim is tethered to a
legislatively declared policy.’” (Gray, supra, 70 Cal.App.5th at p. 237.)
              The court rejected the UCL claim, analogizing to Nolte, where the court
had found that failure to specifically disclose the facility fee was not “unfair” or
“fraudulent” within the meaning of the UCL. The court found the factual distinctions in
Nolte to be immaterial. (Gray, supra, 70 Cal.App.5th at p. 240.) “Indeed, the
circumstances in the instant case are even more compelling than those in Nolte. Not only
did Dignity fully comply with all state and federal disclosure requirements, including the

       We grant the request pursuant to Evidence Code sections 452 and 459 only for the
purpose of demonstrating what the original bill stated. We do not take judicial notice of
Moran’s interpretation of what “admission” to a hospital means, nor do we agree with his
interpretation.

                                              15
requirement that there be signage in its emergency room departments stating how its
pricing information can be accessed (§ 1339.51, subds. (a)(1), (c)), but requiring
individualized disclosure that the hospital will include an ER Charge in its emergency
room billing, prior to providing any emergency medical services, is at odds with the
spirit, if not the letter, of the hospital’s statutory and regulatory obligations with respect
to providing emergency medical care.” (Ibid.) The “multi[-]faceted statutory and
regulatory scheme reflects a strong legislative policy to ensure that emergency medical
care is provided immediately to those who need it, and that billing disclosure
requirements are not to stand in the way of this paramount objective.” (Id. at p. 241.)
The court in Gray unreservedly rejected all of the plaintiff’s contentions regarding the
purported failure to disclose the ER charge as violating with UCL.
               With respect to the CLRA claim, the plaintiff relied on Civil Code section
1770, “subdivisions (a)(5) and (a)(14) of the CLRA. Subdivision (a)(5) . . . prohibits
‘[r]epresenting that goods or services have sponsorship, approval, characteristics,
ingredients, uses, benefits, or quantities that they do not have. . . .’ Subdivision (a)(14)
. . . prohibits ‘[r]epresenting that a transaction confers or involves rights, remedies, or
obligations that it does not have or involve, or that are prohibited by law.’” (Gray, supra,
70 Cal.App.5th at p. 243.) The court found that the plaintiff had failed to allege a claim
under either provision. Subdivision (a)(5) could be based on a failure to disclose, but
only where a duty to do so existed, which it did not in the case at bar. (Id. at pp. 243-
244.) Subdivision (a)(14) generally concerned collateral oral promises, which simply did
not apply. (Id. at p. 245.)
               The plaintiff’s equitable claims were entirely derivative of his UCL and
CLRA claims, and could not stand on their own. Accordingly, the court affirmed the trial
court’s decision in its entirety.

                                              16
              3. Torres
              The next case, Torres, supra, 77 Cal.App.5th at page 504, while reaching
many different conclusions from Gray, ultimately ended up in the same place – with an
affirmance of an order in favor of the defendant hospital. This is another case where the
only issue was Hanford Community Hospital’s (Hanford) failure to disclose an EMS fee.
The operative complaint alleged this fee was not mentioned in the contract the plaintiff
signed, posted in the emergency room, or verbally disclosed to her. (Id. at p. 506.) The
operative complaint alleged Hanford “knows of the following separate but related facts:
(1) an EMS Fee exists, (2) the events that trigger Hospital’s imposition of an EMS Fee,
(3) the EMS Fee has 5 levels, (4) Hospital uses an internal formula to determine which of
the five levels of EMS Fees is imposed on a particular patient, and (5) each level of EMS
Fee is assigned a specific amount and, as a result, the determination of the level of the fee
effectively determines its amount.” (Id. at pp. 510-511.) The plaintiff did not allege a
violation of the statutory schemes regarding disclosure and price transparency, including
the Payer’s Bill of Rights. (Id. at p. 510.) Rather, she alleged that the description of the
EMS fee in the chargemaster was not adequate. (Ibid.)
              The plaintiff sued under the UCL and CLRA and requested declaratory
relief. Hanford moved for judgment on the pleadings, which was ultimately granted
without leave to amend. (Torres, supra, 77 Cal.App.5th at pp. 506-507.) The precise
amount of an EMS fee, the trial court determined, could not be ascertained until after a
patient is evaluated. Accordingly, under section 1339.585, which specifically exempts
emergency treatment, hospitals were not required to provide a cost estimate in the
emergency room. (Torres, at pp. 509-510.)
              The appellate court began its analysis with the CLRA, noting that the
plaintiff had alleged violations of Civil Code section 1770, subdivision (a)(5) and (14),
the same provisions at issue in Gray. (Torres, supra, 77 Cal.App.5th at pp. 508-510.)
The court noted that subdivision (a)(5) was triggered when there was a duty to disclose,

                                             17
including situations where “‘the defendant has exclusive knowledge of material facts not
known or reasonably accessible to the plaintiff’ . . . [or] the defendant actively conceals a
material fact . . . .” (Id. at p. 509.)
               In its discussion of the issue of failure to disclose, the court acknowledged
Nolte and Gray, and stated that its conclusions did not contradict those cases. (Torres,
supra, 77 Cal.App.5th at p. 513.) Yet the court focused its analysis primarily on whether
the EMS fees were “reasonably accessible” to the plaintiff. (Id. at pp. 510-513.) Rather
than focusing on compliance with the extensive state and federal laws on the subject, the
court stated the relevant analysis was whether the plaintiff had “reasonable access” to the
EMS fees under a reasonable person standard. (Id. at p. 511.)
               Hanford argued that compliance with statutory requirements regarding the
accessibility of the chargemaster meant that the plaintiff had reasonable access to the
material facts as a matter of law. (Torres, supra, 77 Cal.App.5th at p. 512.) But the court
noted the operative complaint alleged the chargemaster was “‘unusable and effectively
worthless for the purpose of providing pricing information to consumers’; the
chargemaster failed to include the standardized . . . codes recognized in the industry; and
the chargemaster used coding and highly abbreviated descriptions that are meaningless to
consumers. Accordingly, the SAC further alleges that the chargemaster was meaningless
for purposes of pricing transparency. In effect, [the plaintiff] contends these allegations
are sufficient to allege the material facts were not reasonably accessible and the factual
question of reasonable access cannot be resolved at the pleading stage.” (Ibid.)
               The court agreed with the plaintiff, finding that based on the operative
complaint’s allegations, she had “stated facts sufficient to plead a lack of reasonable
access to (1) the facts that trigger [Hanford’s] imposition of an EMS Fee and (2) the
formula used to determine which level of EMS Fee to impose on an emergency room
patient. In short, we cannot conclude as a matter of law that an objectively reasonable
person who reviewed [Hanford’s] chargemaster and its form of 25 common outpatient

                                             18
procedures could discern the circumstances in which the EMS Fee is charged or how the
amount of the EMS Fee is determined.” (Torres, supra, 77 Cal.App.5th at pp. 512-513.)
              The court noted, however, that this was not the end of the analysis. Failure
to disclose under the CLRA must involve material facts: “‘a fact is “material” if a
reasonable consumer would deem it important in determining how to act in the
transaction at issue.’” (Torres, supra, 77 Cal.App.5th at p. 513.) Materiality is closely
related to causation, and “[a] causal link between the deceptive practice and damage to
the plaintiff is a necessary element of a CLRA cause of action.” (Ibid.) “A
misrepresentation or an omission of fact is material only if the plaintiff relied on it—that
is, the plaintiff would not have acted as he or she did without the misrepresentation or the
omission of fact.” (Ibid.) The court determined that the operative complaint did not
properly plead reliance under the CLRA, and further, taken as a whole, it was not
reasonable to infer that the plaintiff would have acted differently had she known of the
alleged material facts. (Torres, at p. 514.) The EMS fee the plaintiff was charged was
for the highest level of severity. “Therefore, without more particular facts alleged, it is
reasonable to infer that [the plaintiff] suffered severe injuries that posed a significant
threat based on these facts. In turn, it is not reasonable to infer [the plaintiff] would have
obtained treatment elsewhere if the facts about the existence, imposition and amount of
the EMS Fee had been disclosed.” (Ibid.)
              With respect to active concealment, the court concluded the plaintiff had
failed to plead with the required particularity or to sufficiently plead reliance. (Torres,
supra, 77 Cal.App.5th at p. 514.) Accordingly, the court affirmed the trial court’s
decision to grant judgment on the pleadings.

              4. Saini
              The appeal in Saini, like Torres and Gray, was almost entirely about the
viability of a claim for the alleged failure to disclose an EMS fee. By the time the case

                                              19
reached the appellate court, the UCL and declaratory relief claims had been eliminated,
leaving a single cause of action under the now-familiar Civil Code section 1770,
subdivision (a)(5) and (14) of the CLRA. The complaint’s allegations were very similar
to those at issue here. (Saini, supra, 80 Cal.App.5th at pp. 1056-1059.) The trial court
sustained Sutter Health’s demurrer without leave to amend, “concluding that defendant
has no duty to post notice of the EMS Fee in its emergency room. The trial court ruled
that the allegations of the complaint show that defendant has complied with its statutory
disclosure obligations and that there is no duty to make an additional disclosure of the
EMS Fee in light of the public policy reflected in federal and state statutes that
emergency room care be provided to patients without delay or questioning about their
ability to pay.” (Id. at p. 1059.)
              The appellate court affirmed, rejecting the plaintiff’s arguments that Gray
was wrongly decided.
                       10
                            (Saini, supra, 80 Cal.App.5th at pp. 1056-1057.) “We agree
[with Gray that] defendant does not have a duty under the CLRA to disclose the EMS
Fee by posting additional signage in its emergency rooms. As plaintiff’s complaint
acknowledges, the EMS Fee is disclosed in the hospital’s chargemaster in compliance
with state and federal law. Making the unsupported assumption that this disclosure is
insufficient and does not in fact convey the necessary information to one seeking this
information before receiving emergency room treatment, there nonetheless is no basis to
require further disclosure.” (Id. at p. 1061.)
              The plaintiff argued a duty to disclose based on the “‘exclusive
knowledge’” and “‘intentional concealment’” prongs of the CLRA. (Saini, supra, 80
Cal.App.5th at p. 1061.) The court stated: “The hospital has a duty under the CLRA, as
well as the many statutes cited above [including the Payer’s Bill of Rights], to disclose
the fees it intends to charge for its goods and services, including the EMS Fee. It does so

 Gray was decided by the First Appellate District, Division One, and Saini was decided
10

by the First Appellate District, Division Four.

                                              20
in its chargemaster, to which signage in the emergency room directs those interested.
The question here, however, is whether defendant has a duty to call attention to the EMS
Fee by additional signage in the emergency room visible to a person seeking emergency
care. The Gray court concluded that for the reasons it explained no such duty exists, and
we agree.” (Id. at p. 1062, fn.omitted.) The court further noted that the Gray court
“carefully considered the competing interests served by ensuring that patients are fully
apprised in advance of the costs of emergency services and ensuring that patients have
timely access to emergency services.” (Ibid.) “[A]s Gray makes clear, the state and
federal legislative bodies are in a superior position to balance these competing interests
and have done so in crafting the applicable ‘multifaceted statutory and regulatory
scheme.’ [Citation.] Our conclusion is consistent with the balance struck by the existing
regulatory scheme and does not, as plaintiff suggests, disregard the ‘important policy in
favor of providing pricing transparency to medical patients.’” (Id. at p. 1063.)
              The court also distinguished Torres, stating that unlike the complaint in
Torres, “plaintiff’s complaint expressly disavows any claim that ‘defendant fails to list an
EMS Fee as a line item in its published chargemasters, or that defendant fails to list the
price of such fees in its chargemasters.’” (Saini, supra, 80 Cal.App.5th at p. 1062, fn. 8.)
Rejecting the remainder of the plaintiff’s arguments, the court affirmed the trial court’s
ruling sustaining the demurrer without leave to amend. (Id. at pp. 1063-1066.)

              5. Naranjo
              After briefing in this case was completed, the Fifth Appellate District
decided Naranjo, supra, 90 Cal.App.5th 1193, and as we mentioned above, shortly after

                                             21
oral argument, the California Supreme Court granted review.          Again, Naranjo case was
                                                                11

about the propriety of an EMS fee under the UCL and CLRA. The plaintiff’s complaint
alleged “he was never warned or notified” in the conditions of admission or by “‘signage
in the emergency room’” that he would be charged an EMS fee. (Naranjo, at p. 1198.)
                Following Torres, also decided by the Fifth Appellate District, and the line
of cases cited therein, primarily regarding the duty to disclose known facts, the Naranjo
court determined the plaintiff had adequately stated claims under the UCL and CLRA.
                In sum, Naranjo, supra, 90 Cal.App.5th at page 1193, is the only case
which allowed this type of case to proceed on the merits. While Torres tacitly rejected
the proposition that the relevant state and federal statutes are the only source of a
hospital’s duty to disclose an EMS fee, the court found no reliance under the CLRA.
(Torres, supra, 77 Cal.App.5th at pp. 512-514.) Both Gray and Saini held that hospitals
have no duty to disclose beyond the requirements of the state and federal regulatory
schemes. (Saini, supra, 80 Cal.App.5th at pp. 1061-1062; Gray, supra, 70 Cal.App.5th at
pp. 241-243.)

E. “Implied” Safe Harbor
                Moran contends the trial court “effectively” found an “implied safe harbor”
for defendants. As we noted in Moran, supra, 3 Cal.App.5th at page 1140, “‘[w]hen
specific legislation provides a “safe harbor,” plaintiffs may not use the general unfair
competition law to assault that harbor.’” (See Cel-Tech Communications, Inc. v. Los
Angeles Cellular Telephone Co. (1999) 20 Cal.4th 163, 182.) We do not find the trial
court’s order wrongfully “implied” a safe harbor. It simply found that no duty existed to

  The same day the California Supreme Court granted review in Naranjo, it also granted
11

review in Capito v. San Jose Healthcare System (Apr. 6, 2023, H049646) [nonpub. opn.],
review granted July 26, 2023, S280018, S279862. In that case, the Sixth Appellate
District affirmed the trial court’s dismissal of the case, rejecting Torres and following
Gray and Saini.

                                              22
post Moran’s requested signage. (See Saini, supra, 80 Cal.App.5th at p. 1065; Gray,
supra, 70 Cal.App.5th at p. 241.)

F. UCL Allegations Based on EMS Fee
               The UCL’s purpose is “to safeguard the public against the creation or
perpetuation of monopolies and to foster and encourage competition, by prohibiting
unfair, dishonest, deceptive, destructive, fraudulent and discriminatory practices by
which fair and honest competition is destroyed or prevented.” (Bus. & Prof. Code,
§ 17001.) The law prohibits “any unlawful, unfair or fraudulent business act or practice
and unfair, deceptive, untrue or misleading advertising.” (Bus. & Prof. Code, §§
17200, 17203, 17204.)
               An “unlawful” act or practice is “‘“‘anything that can properly be called a
business practice and that at the same time is forbidden by law.’”’” (Cel-Tech, supra, 20
Cal.4th at p. 180; see Moran, supra, 3 Cal.App.5th at p. 1140.) As interpreted by this
district, “unfair” is defined as stated in Gregory v. Albertson’s, Inc. (2002) 104
Cal.App.4th 845, 854: “[W]here a claim of an unfair act or practice is predicated on
public policy, . . . the public policy which is a predicate to the action must be ‘tethered’ to
specific constitutional, statutory or regulatory provisions.” (See Graham v. Bank of
America, N.A. (2014) 226 Cal.App.4th 594, 613.) A “fraudulent” act or practice is one
likely to deceive the public. (Shaeffer v. Califia Farms, LLC (2020) 44 Cal.App.5th
1125, 1135.)
               Pursuant to the complaint and as relevant to this appeal, the following acts
by the Hospital allegedly violated the UCL: “unfairly and unlawfully charg[ing] their
emergency patients an EMS Fee and fail[ing] to inform and/or conceal[ing] from their
patients their uniform policy of billing a substantial, unreasonable, and undisclosed EMS
Fee in addition to the charges for individual items of treatment or services provided to the
patient.” The complaint further alleged: “Knowledge of such an EMS Fee would be a

                                              23
substantial factor in a patient’s decision as to whether to remain at the hospital and
proceed with treatment.”
              The legislatively declared policy that makes this practice unfair, the
complaint claimed, is the violation of the CLRA. The complaint does not allege that the
Hospital violated the UCL by failing to list the EMS fee in the published chargemaster,
and Moran conceded that the Hospital filed its chargemaster with the OSHPD and posted
it on its own web site as of the date the complaint was filed.
                                                                 12

              As discussed above, as well as in Gray and Saini, the California Legislature,
the United States Congress, and numerous rulemaking bodies have already decided what
pricing information to make available in a hospital’s emergency room. Just as importantly,
they have decided what not to include in those requirements. The reason for this extensive
statutory and regulatory scheme is to strike a balance between price transparency and
dissuading patients from avoiding potentially life-saving care due to cost. (See, e.g., §§
1339.51, subd. (a)(1), 1339.585 [exemption to requirement of written estimates for
emergency patients]; 42 U.S.C. § 1395dd(a), (h) [prohibiting delay of treatment to inquire
about ability to pay]; 26 C.F.R. § 1.501(r)–4(c)(2) [prohibiting actions that discourage
individuals from seeking emergency care]; 84 Fed.Reg. 65524, 65536 (Nov. 27, 2019)
[price transparency provisions of Affordable Care Act do not require hospitals to post
signage about cost of care].)
              While “conduct not expressly prohibited by statute may nevertheless be
found to be an ‘unfair’ business practice under the UCL [citation], the alleged conduct
must nevertheless meet the substantive definition of an ‘unfair’ practice to be actionable,

  Moran claims the trial court improperly found that the Hospital complied with various
12

provisions of the Payers’ Bill of Rights. What is relevant here is whether Moran properly
alleged a violation of the Payers’ Bill of Rights, which he did not. The complaint
disavowed alleging a violation of the relevant provisions of the Payers’ Bill of Rights that
deal with disclosing hospital prices and fees.

                                             24
which the failure to disclose Gray complains of here, does not . . . .” (Gray, supra, 70
Cal.App.5th at p. 242.)
                    Given that both the state and federal governments have thoroughly
considered patients’ need for price transparency about hospital charges, we find that as a
matter of law, in accord with Gray and Saini, the Hospital’s policy of not providing
additional signage or other warnings about the EMS fee does not state a claim for unfair,
unlawful, or fraudulent conduct within the UCL. “[R]equiring individualized disclosure
that the hospital will include an ER Charge in its emergency room billing, prior to
providing any emergency medical services, is at odds with the spirit, if not the letter, of
the hospital’s statutory and regulatory obligations with respect to providing emergency
medical care.” (Gray, supra, 70 Cal.App.5th at p. 240; see Saini, supra, 80 Cal.App.5th
at p. 1060.)
               13
                    A hospital’s duty to list, post, write down, or discuss fees it may or may not
charge an emergency room patient starts and ends with its duty to list prices in the
chargemaster, which must be available in accordance with state law. (See Id. at p. 1062.)
                    To the extent that Torres and Naranjo hold otherwise, we decline to follow
them. Further, we note that the chargemaster in Torres was allegedly “‘unusable and
effectively worthless for the purpose of providing pricing information to consumers,’”
and “failed to include the standardized CPT codes recognized in the industry.” (Torres,
supra, 77 Cal.App.5th at p. 512.) Such allegations are not present here. Unlike in
Torres, the Contract Moran signed expressly referred the patient to the chargemaster for a
description of fees, which, as our prior opinion stated, “provided a means by which a
patient can ascertain the amount due for the treatment and services reasonably provided.”
(Moran, supra, 3 Cal.App.5th at p. 1147.) The Hospital’s chargemaster listed CPT codes
and described the 25 most common procedures, including EMS fees for levels two

 The fact that Moran claims that he seeks additional disclosures through the written
13

Contract that were not at issue in Gray is a distinction without a difference. The EMS fee
was included in the chargemaster, as required by law.

                                                  25
through four, in plain English. The allegations regarding the EMS fee were properly
stricken from the UCL cause of action.

G. CLRA Claims Based on EMS Fee
              As relevant to this appeal, the alleged portions of the CLRA Moran claims
the hospital violated were Civil Code section 1170, subdivision (a)(5) and (14) – the
same provisions at issue in Saini, supra, 80 Cal.App.5th at page 1061, and Gray, supra,
70 Cal.App.5th at page 243. Subdivision (a)(5) prohibits “[r]epresenting that goods or
services have sponsorship, approval, characteristics, ingredients, uses, benefits, or
quantities that they do not have . . . .” Subdivision (a)(14) prohibits “[r]epresenting that a
transaction confers or involves rights, remedies, or obligations that it does not have or
involve, or that are prohibited by law.”
              Under the CLRA, the failure to disclose is limited to a few narrow factual
situations. Here, Moran argues the Hospital had “exclusive knowledge” and
“intentionally conceal[ed]” the EMS fee. The court in Saini, which faced the same
arguments, rejected the allegations. “[T]here is no withholding of information that is
provided on the hospital’s chargemaster.” (Saini, supra, 80 Cal.App.5th at p. 1062.)
              We reject Moran’s contention that Gray and Saini were wrongly decided.
To the extent that Moran would have us reject those cases and rely on Torres, as we
discussed above, that case does not help him when it comes to the issue of reliance,
another essential element of a CLRA cause of action. As defendants point out, earlier
versions of Moran’s complaint undercut his claim that he “relied on not being billed” an
EMS fee. Allegations in earlier complaints continue to bind plaintiff even if the
allegation is omitted from subsequent versions. (Panterra GP, Inc. v. Superior
Court (2022) 74 Cal.App.5th 697, 711.) To the extent Moran relies entirely on Naranjo,
we disagree and decline to follow it.
              In his initial complaint, Moran alleged that “patients such as Plaintiff, who

                                             26
experienced a medical emergency, have no opportunity to shop for prices or negotiate
fixed pricing terms in advance.” In the fifth amended complaint, he alleged that “in an
emergency care situation,” it is “impossible to look up, compare, or negotiate fixed
pricing amounts or payment terms in advance of receiving emergency
treatment/services.”
              Further, Moran’s history at each of his three visits suggest serious and
legitimate medical emergencies where he would have had no realistic opportunity to
compare prices or consider leaving. At each visit, he was charged a level four EMS fee,
the second highest, indicating a “high severity” emergency. He received CT scans at his
first and third visits. None of these facts suggest a reasonable inference that disclosing
the EMS fees would have resulted in Moran seeking treatment elsewhere, which would
                                                                      14

doom his allegations if we relied on Torres. (Torres, supra, 77 Cal.App.5th at pp. 513-
514.)
              Accordingly, for the same reasons that Gray and Saini articulate so well,
we find no duty to disclose the EMS fee under the CLRA beyond those imposed by
existing state and federal laws and regulations. But even if we were to disagree and find
such a duty, Moran failed to adequately plead reliance. The trial court, therefore,
properly struck those allegations from the complaint.

H. The Declaratory Relief Claims based on the EMS Fee
              Moran’s declaratory relief claim with respect to the EMS fee, like his UCL
and CLRA claims, relies entirely on the idea that the Hospital was required to take steps
beyond what is required by state law to inform him of those fees. We disagree. As the

  Moran, in support of class certification, submitted a declaration stating otherwise.
14

Because the declaration is outside the pleadings and the facts stated therein are not
subject to judicial notice, the declaration must be disregarded in the context of a demurrer
or motion to strike. (See Mt. Hawley Ins. Co. v. Lopez (2013) 215 Cal.App.4th 1385,
1426.)

                                             27
court noted in Gray, supra, 70 Cal.App.5th at page 245, the claim for declaratory relief
“has no independent vitality apart from his UCL and CLRA claims. Rather, it is a request
for particular forms of equitable relief. [Citation.] Since his UCL and CLRA claims fail,
so too does his request for declaratory . . . relief.” The parts of the declaratory relief
action referring to the EMS fee were properly stricken from the complaint.

I. Moran’s Claimed “Errors” in the Trial Court’s Ruling
               Despite the fact that our review is de novo and the fact that “we review [the
trial court’s] ruling, not its reasoning” (Qualcomm, Inc. v. Certain Underwriters at
Lloyd’s, London (2008) 161 Cal.App.4th 184, 204), Moran has chosen to organize the
much of the argument section of his opening brief by picking apart alleged “errors” made
by the trial court.
                      15
                           This is unhelpful as an organizational principle in the instant
procedural context, and most of the points raised are either irrelevant or subsumed by our
prior discussion. None of the contentions Moran raises about the trial court’s purportedly
faulty order constitute reversible error.

   For example, Moran claims the trial court relied extensively on Nolte, which is
15

“nothing like this case” (boldfacing & capitalization omitted), and did not “acknowledge
the overwhelming factual differences between [Nolte and Gray].” The trial court’s job is
to reach the correct ruling, which it did. It does not matter which cases it relied on too
little or too much if it reached the right decision. Relying on the “wrong” case while
reaching the right answer is not reversible error.

                                                   28
                                            III
                                      DISPOSITION
              Moran’s request for judicial notice is granted. The court’s order striking
certain portions of the complaint is affirmed. Defendants are entitled to their costs on
appeal.

                                                  MOORE, J.

WE CONCUR:

O’LEARY, P. J.

BEDSWORTH, J.

                                            29