Healthcare Provider Sues Companies Over Outstanding Service Bill

Silver Peaks, LLC (Silver Peaks) filed suit against CareMore Health Plan (Caremore), Country Villa Belmont Heights Healthcare Center (CVBHHC), and Rockport Healthcare Support Services (Rockport) Thursday and is seeking damages for fraud, breach of contract, account stated, quantum merit, and unjust enrichment. The suit, filed in the County of Los Angeles, also demands a trial by jury.

Silver Peaks is a “home care organization which provides non-medical services to patients that reside in their own home or that live in an elderly care facility.” One of the services encompassed in the non-medical services provided by Silver Peaks is sitter services. Caremore is a “medical group health plan, care delivery system and insurer that works with a subscriber member’s insurance plan to deliver needed care to subscribing members.”

Caremore and CVBHHC allegedly entered into an agreement in which Caremore would “cover patient sitter services” for a patient. After the agreement was arranged, Caremore contacted Silver Peaks and requested that they provide the services to the patient, which they did. After the period in which the patient needed services concluded, the plaintiff sent CVBHHC a bill amounting to $6,894.00.

Four months later, when CVBHHC still had not completed the payment, Silver Peaks used an attorney to send a letter demanding payment from the center. The attorney also called the manager of CVBHHC and left a message regarding the payment. Eventually, the manager, Lourdes Rivera, called the plaintiff’s attorney back and explained several discrepancies she had noticed on the bill. She detailed that Caremore should have cancelled the services after one week, leaving CVBHHC only responsible for one week of the services (totaling $3,447.00).

Despite this message from Rivera, the plaintiff argues that the aforementioned agreement “creates an obligation for Defendants to pay invoice 500148.” Silver Peaks is alleging fraud upon the defendants as they allowed Silver Peaks to “provide their services knowing that they had no intentions to pay any amount due to Silver Peaks for the services provided.” The parent company of CVBHHC, Rockport, has allegedly withheld payment from Silver Peaks before, causing the plaintiff to request additional punitive damages from them in the form of $100,000.00. Further, the plaintiff explains that due to the time they have wasted trying to track down and procure payment, they are entitled to punitive damages.

The defendant’s failure to submit payment to Silver Peaks has led them to also allege breach of contract and unjust enrichment against Caremore, CVBHHC, and Rockport. The violations have led to damages in the form of the amount owed in addition to interest and litigation costs totaling $36,000.00. The plaintiff is ultimately seeking a favorable judgement regarding the amount owed, the amount owed plus interest, litigation costs totaling no less than $50,000.00, punitive damages against Rockport totaling $100,000.00, as well as any other relief deemed necessary.

The plaintiff is represented by Crystal Hayes Hill, while the defendant is represented by Von Behren and Hunter.