Filed 4/10/13 (unmodified opn. attached) CERTIFIED FOR PUBLICATION IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA FIRST APPELLATE DISTRICT DIVISION THREE SHAHIN AMRALI et al., Plaintiffs and Appellants, A135431 v. CALIFORNIA PHYSICIANS WELFARE (Alameda County TRUST et al., Super. Ct. No. RG10868683) Defendants and Respondents. Appellants Shahin Amrali, E.A., M.D., and San Mateo Medical Associates, Inc. (together, Amrali), appeal from the trial court‟s judgment dismissing their complaint for declaratory and injunctive relief against California Physicians Welfare Trust (the Trust), Coventry Healthcare, Inc., Medi-Cal, and California Department of Health Care Services (collectively respondents) on the ground that the complaint failed to state a cause of action. Amrali sought judicial review of respondents‟ denial of its claim for reimbursement of costs Amrali incurred in providing laboratory services to certain of its patient-assignors and reimbursement of those patient-assignors‟ bills for services received. Amrali contended that it had standing to assert its patient-assignors‟ rights under California‟s medical assistance fraud statutes, Health and Safety Code sections 1471, 1472 and 1473,1 because 1 Further statutory references are to the Health and Safety Code unless otherwise indicated. 1 it was a prevailing party in its claims for reimbursement for services rendered to its patient- assignors. We agree with Amrali that it has standing under these statutes to assert a patient‟s claim to the provider‟s right to payment for services rendered. As we explain below, Amrali may assert its patient-assignors‟ rights because, having been paid by the patient, it has a colorable claim to those rights.2 FACTUAL AND PROCEDURAL BACKGROUND In April 2009, Amrali submitted to Medi-Cal a claim for reimbursement of outstanding claims of patients whose care it provided. Amrali sought reimbursement in the amount of $20,193.25. According to Amrali‟s complaint, these patient-assignors had received services that qualified them as Medicare Part B enrollees and as beneficiaries under Medi-Cal, but they had not paid for the care they received. In July 2009, the Department of Health Care Services (DHS) issued a “Notice of Deficiency” stating that the claim was disallowed for failure to comply with DHS‟s Medicaid Provider‟s Manual provisions requiring the signature of an individual who receives treatment on the assigned claim. Amrali requested and was given an administrative hearing. At the hearing, Amrali‟s claim was denied, and a DHS hearing officer agreed that Amrali had not provided “medical necessity” documentation and that Amrali had not demonstrated that it was acting as a physician within the meaning of Health and Safety Code section 14059.5. Amrali appealed the ruling to the director of DHS, and the director upheld the decision. Amrali then filed a petition for writ of administrative mandamus (Code Civ. Proc., § 1094.5) against DHS and the Trust in the Alameda County Superior Court (the superior court action). DHS and the Trust demurred to Amrali‟s complaint, contending the trial 2 In their respondents‟ brief, respondents contend Amrali lacks standing because it is an assignee of patient-assignors who have a cause of action against DHS, not Amrali. Respondents do not dispute Amrali‟s position that Amrali has the right to sue as assignee of claims its patient-assignors are owed. 2 court was without jurisdiction because DHS had not received the statutorily required notice before it disallowed Amrali‟s claim. Amrali then filed a first amended complaint, which was the operative complaint at the time the trial court ruled on the demurrer. The first amended complaint alleged that Amrali provided laboratory services to patients whose care qualified them for Medicare Part B and Medicaid; in addition, the patients had qualified for or received services from the emergency medical services system; and they had received “diagnosis, treatment and care in excess of $20,193.25.” The complaint alleged that the patient-assignors had not paid for the care they received. The operative complaint added claims for declaratory relief to the cause of action seeking administrative mandamus. It sought a declaration that Medi-Cal and the DHS/Trust “are required to reimburse a medical provider, or provider‟s assignee, for costs of services paid by the Department of Health Care Services or Medi-Cal to patients” whose “care is medically necessary.” It also sought a declaration that DHS had failed to follow statutory procedures in denying Amrali‟s claim and that DHS‟s decision denying Amrali‟s claim was “ultra vires, arbitrary, capricious and an abuse of discretion.” Amrali‟s complaint also added causes of action alleging violations of the provisions of Medi-Cal, the California Welfare and Institutions Code, and the common law. As relevant to this appeal, the Medi-Cal claims sought to enforce the right to reimbursement for medical services provided to patients, alleging a right of reimbursement based on principles of indemnification, unjust enrichment, and quantum meruit. Amrali‟s California Welfare and Institutions Code claims, based on violations of its alleged right of indemnification, sought a declaration of its right to sue under Health and Safety Code sections 1471 and 1472, as well as a declaration that the Trust‟s failure to respond to its writ petition constituted a waiver of the right to deny reimbursement. Finally, Amrali‟s common law claims asserted unjust enrichment and breach of contract, respectively, based on the same grounds alleged in its Medi-Cal claims. The Trust demurred to Amrali‟s complaint. It argued that it was not necessary for Amrali to show standing because the only claims before the trial court were the causes of 3 action seeking administrative mandamus relief under Code of Civil Procedure section 1094.5, but Amrali had not exhausted its administrative remedies and was not pursuing an administrative mandate action.3 Alternatively, the Trust contended that, to the extent Amrali‟s claims were based on asserted Medi-Cal and California Welfare and Institutions Code violations, Amrali lacked standing because it was not seeking to enforce rights that belonged to its patient-assignors, but to its assignees. Amrali‟s demurrer to the Trust‟s petition for writ of administrative mandamus was also pending at the same time as the Trust‟s demurrer. The trial court heard both demurrers and denied the writ petition in March 2010. However, on Amrali‟s motion, the court entered an order staying the superior court proceedings in order to allow this court to determine the appeal from the denial of the writ petition, which was then pending before this court (D063781). In April 2010, the trial court sustained the Trust‟s demurrer without leave to amend, determining that Amrali had failed to exhaust its administrative remedies as required by Code of Civil Procedure section 1094.5. The court also sustained the demurrer to Amrali‟s Medi-Cal and California Welfare and Institutions Code claims with leave to amend. The court concluded that Amrali was not a physician or health care provider and lacked standing to assert claims under these codes. The court dismissed the remainder of the complaint. This timely appeal followed. We initially dismissed the appeal, stating that it was from a nonappealable order denying a motion for judgment on the pleadings because it was not an appealable final judgment, as there was an outstanding appeal from the order denying Amrali‟s writ petition. Amrali sought and we granted a writ of supersedeas to reinstate the appeal on the Court of Appeal‟s calendar, staying all trial court proceedings. We now reverse. 3 The Trust did not argue that Amrali‟s complaint failed to state a cause of action, but claimed Amrali lacked standing and therefore the complaint could not be amended to add parties with standing. 4  DISCUSSION Amrali contends that the trial court erred in sustaining the demurrer to its Medicare, Health and Safety Code and California Welfare and Institutions Code claims. In the unpublished portion of this opinion, we will consider whether the trial court erred in sustaining the demurrer to Amrali‟s Medicare and Health and Safety Code claims. We conclude the trial court correctly sustained the demur