Jones v. Regents of the University of California

Background

Nadezhda Jones was enrolled in Medi-Cal and sought dental treatment at the UCSF School of Dentistry, which accepted Medi-Cal Dental insurance. She sought treatment related to permanent partial dentures. After receiving an estimated bill, Jones complained that services such as examinations, X-rays, crowns, extractions, and partial dentures should have been covered. She and her patient advocate disputed the billing with UCSF and other entities.

The court stated that UCSF decided to terminate Jones as a patient because of disruptive behavior by Jones and her advocate. Jones alleged that UCSF instead retaliated against her for complaining about the charges and that the termination effectively ended her Medi-Cal dental benefits because other dentists were unwilling to accept Medi-Cal Dental patients. She brought 26 causes of action against the Regents of the University of California, Biana Roykh, and the California Department of Health Care Services (DHCS).

Motions to Dismiss

The defendants moved to dismiss under Federal Rule of Civil Procedure 12(b)(6), which permits dismissal when a complaint does not state a legally sufficient claim. The court considered the allegations in Jones’s first amended complaint and the attached administrative record. It also found that Jones’s opposition largely repeated allegations rather than addressing the defendants’ arguments or explaining how the pleading could be fixed.

Federal Civil-Rights Claims

Jones brought federal claims under 42 U.S.C. § 1983, a statute that allows claims against a person who, acting under state authority, violates federal rights. The court held that the Regents and DHCS are state entities, or “arms of the state,” and therefore are not “persons” who can be sued under § 1983. The same rule applied to state officials sued in their official capacities. The court dismissed those claims without leave to amend.

The court explained that a § 1983 claim against Roykh in her personal capacity would require facts showing that she personally caused a violation of Jones’s federal rights. It found that Jones’s allegations generally referred to the defendants or the Regents rather than Roykh specifically. The court also found that the allegations about Roykh’s letter, which explained the denture-coverage decision and patient termination, were insufficient. It further noted that the allegations showed Jones remained a Medi-Cal beneficiary and could seek treatment from other Medi-Cal providers. The court dismissed Jones’s federal claims without leave to amend.

Other Claims

The court dismissed Jones’s California Constitution claim because she alleged no facts supporting it. It dismissed her Unruh Civil Rights Act claim because, even assuming that her inability to chew qualified as a disability, the allegations showed that the patient termination was based on uncooperative and disruptive behavior rather than disability or discriminatory intent. The court stated that the same reasoning defeated Jones’s claims under the Americans with Disabilities Act, the Rehabilitation Act, Section 1557 of the Affordable Care Act, and California Government Code section 11135.

The court dismissed Jones’s whistleblower-retaliation claim under California Health and Safety Code section 1278.5 because DHCS was not a covered health facility and Jones’s complaints about termination as a patient were not protected whistleblower activity under the statute. It dismissed her intentional-infliction-of-emotional-distress claim because she did not allege extreme and outrageous conduct or emotional distress meeting the required high standard.

The court dismissed the fraud claim because Jones did not allege that DHCS participated in the billing statement, relied on the alleged false information, or suffered damages from it. It dismissed the negligence claim because Jones did not plead sufficient facts showing the required elements, particularly damage; the court also noted that she did not receive treatment from UCSF Dental or Roykh. It dismissed the breach-of-contract claim because Jones did not adequately allege a contract or damages. Finally, it dismissed the California Unfair Competition Law claim against Roykh because Jones had not alleged an injury in fact or loss of money or property.

Leave to Amend and Other Motions

The court concluded that amendment would be futile. Jones had already amended her complaint once, did not substantively respond to most dismissal arguments, and could not allege additional facts that would save the claims based on the complaint and attached administrative record. The court therefore granted the defendants’ motions to dismiss without leave to amend.

The court also denied Jones’s motion to certify the earlier order denying remand for interlocutory appeal. It found that she had not shown the exceptional circumstances required for such an immediate appeal and that the appeal would likely become moot in light of the dismissal. The court denied Jones’s motions to stay as moot. It directed the clerk to enter a separate judgment and close the file.