Kaiser Health Foundation Hit With $82.3 Million Verdict in Breach of Contract Case

Pomona Valley Hospital Medical Center v. Kaiser Foundation Health Plan, Inc. (Los Angeles Super Ct. No. KC069796): Plaintiff sued Kaiser Foundation Health Plan Inc. after Kaiser terminated a long-running reimbursement contract in 2017. From October 2017 to March 2020, the hospital billed $136.6 million for roughly 4,100 emergency claims for Kaiser members, but Kaiser only paid about $39.8 million. Following the hospital’s 2019 quantum meruit lawsuit over underpaid emergency services, a jury initially awarded Pomona Valley $66.1 million in damages; however, the trial judge conditionally granted Kaiser a new trial on the grounds that an expired 2004 contract had been improperly admitted as evidence. Although the hospital initially accepted a remittitur, cross-appeals were filed, leading the Court of Appeal to rule in 2026 that the 2004 agreement was properly considered by the jury. The appellate court directed the trial court to vacate the new-trial order and reinstate the original jury award, which a Los Angeles County Superior Court judge finalized at $82.3 million with statutory prejudgment interest and costs included. Plaintiff was represented by King & Spalding LLP. Defendant was represented by Crowell & Moring.