Cedars Sinai Medical Center v. Mid-West National Life Insurance

ORDER GRANTING IN PART AND DENYING IN PART DEFENDANTS’ MOTION FOR SUMMARY JUDGMENT OF ALL CLAIMS

PAEZ, District Judge.

I

Introduction

This action involves the medical insurance industry practice of “pre-certification,” whereby a medical insurer confirms to a health care provider that an insured’s coverage is in effect prior to treatment of the insured by the health care provider. Pre-certification normally consists of two parts: a verification of coverage and a certification that the proposed treatment is medically necessary.

Plaintiff Cedars-Sinai Medical Center (“Cedars”) brought this action for…