{"id":115954,"date":"2021-03-09T22:44:48","date_gmt":"2021-03-10T06:44:48","guid":{"rendered":"http:\/\/69.46.6.243\/?p=115954"},"modified":"2021-03-09T22:44:48","modified_gmt":"2021-03-10T06:44:48","slug":"ag-becerra-secures-preliminary-approval-of-settlement-with-sutter-health-resolving-allegations-of-anti-competitive-practices","status":"publish","type":"post","link":"https:\/\/new.thepinetree.net\/?p=115954","title":{"rendered":"AG Becerra Secures Preliminary Approval of Settlement with Sutter Health Resolving Allegations of Anti-Competitive Practices"},"content":{"rendered":"<p>Sacramento, CA&#8230;California Attorney General Xavier Becerra today applauded Judge Massullo\u2019s\u00a0preliminary approval of the groundbreaking settlement reached with Sutter Health (Sutter) in December 2019. The settlement\u00a0agreement\u00a0resolves allegations by the Attorney General, the United\u00a0Food and Commercial Workers International Union and Employers Benefit Trust\u00a0(UEBT),\u00a0and class action plaintiffs,\u00a0that Sutter\u2019s anticompetitive practices led to higher healthcare costs for consumers in Northern California compared to other places in the state.\u00a0The\u00a0settlement requires\u00a0Sutter to pay $575 million in compensation,\u00a0prohibits anticompetitive conduct, and requires Sutter to follow certain practices\u00a0to restore competition in California\u2019s healthcare markets.\u00a0Today&#8217;s preliminary approval\u00a0is a big\u00a0step towards getting this settlement in place so it can\u00a0start helping Californians.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/new.thepinetree.net\/wp-content\/uploads\/2019\/07\/cadoj.jpg\" alt=\"\" width=\"225\" height=\"224\" class=\"alignnone size-full wp-image-82791\" srcset=\"https:\/\/new.thepinetree.net\/wp-content\/uploads\/2019\/07\/cadoj.jpg 225w, https:\/\/new.thepinetree.net\/wp-content\/uploads\/2019\/07\/cadoj-150x150.jpg 150w, https:\/\/new.thepinetree.net\/wp-content\/uploads\/2019\/07\/cadoj-30x30.jpg 30w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><\/p>\n<p>\u201cToday\u2019s settlement represents a huge step toward making healthcare more accessible and affordable for patients who need it, especially for Northern California patients served by Sutter,\u201d\u00a0<b>said Attorney General Becerra.\u00a0<\/b>\u201cThis landmark settlement will require Sutter to stop practices that drive patients into more expensive health services and to operate with more transparency. The California Department of Justice will continue to work to keep the healthcare market competitive so that patients, families, and employers aren\u2019t left holding the bag when big players\u00a0dominate the market.\u201d<\/p>\n<p>This settlement is the result of litigation that began in 2014\u00a0when the\u00a0UEBT\u00a0and numerous individual plaintiffs \u2014 later consolidated into a class action \u2014 filed their lawsuit challenging Sutter\u2019s practices in rendering services and setting prices. They sought compensation for what they alleged were unlawful,\u00a0anticompetitive business practices, which caused them to pay more than necessary for healthcare services and products. In March of 2018,\u00a0<a href=\"https:\/\/oag.ca.gov\/news\/press-releases\/attorney-general-becerra-sues-sutter-health-anti-competitive-practices-increase\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/oag.ca.gov\/news\/press-releases\/attorney-general-becerra-sues-sutter-health-anti-competitive-practices-increase&amp;source=gmail&amp;ust=1615431121902000&amp;usg=AFQjCNGsKpckVNTP93tySI__PdRGs9vR9w\">Attorney General Becerra filed a similar lawsuit against Sutter<\/a>\u00a0on behalf of the people of California, principally seeking injunctive relief to compel Sutter to correct its anticompetitive business practices moving forward.\u00a0The separate lawsuits were combined by the court into one case. In October of 2019, on the eve of trial, the parties reached an agreement to settle. The settlement was filed with the court on December 19, 2019, together with an unopposed motion for its preliminary approval.\u00a0Today\u2019s ruling grants\u00a0preliminary approval and following the required\u00a0class notice period,\u00a0sets\u00a0a hearing date\u00a0for final approval.<\/p>\n<p>With today\u2019s approval of the settlement, Sutter is required to:<\/p>\n<ul>\n<li><b>Pay $575 million<\/b>\u00a0to compensate employers, unions, and others covered under the class action,\u00a0and to cover costs and fees associated with the legal efforts;<\/li>\n<li><b>Limit what it charges patients for out-of-network services,\u00a0<\/b>helping ensure that patients visiting an out-of-network hospital do not face outsized, surprise medical bills;<\/li>\n<li><b>Increase transparency\u00a0<\/b>by permitting insurers, employers, and self-funded payers to provide plan members with access to pricing, quality, and cost information, which helps patients make better care decisions;<\/li>\n<li><b>Halt measures that deny patients access to lower-cost plans,<\/b>\u00a0thus allowing health insurers, employers, and self-funded payers to offer and direct patients to more affordable health plan options for networks or products;<\/li>\n<li><b>Stop all-or-nothing contracting deals,\u00a0<\/b>thus<b>\u00a0<\/b>allowing insurers, employers, and self-funded payers to include some but not necessarily all of Sutter\u2019s hospitals, clinics, or other commercial products in their plans\u2019 network.<\/li>\n<li><b>Cease anticompetitive bundling of services and products<\/b>\u00a0which forced insurers, employers, and self-funded payers to purchase for their plan offerings more services or products from Sutter than were needed.\u00a0Sutter must now offer a stand-alone price that must be lower than any bundled package price to give insurers, employers, and self-funded payers more choice;<\/li>\n<li><b>Cooperate with a court-approved compliance monitor<\/b>\u00a0to ensure that Sutter is following the terms of the settlement for at least 10 years. The monitor will receive and investigate complaints and may present evidence to the court; and<\/li>\n<li><b>Clearly set definitions on clinical integration and patient access considerations.<\/b>\u00a0The settlement makes clear that for Sutter to claim it has clinically integrated a system, it must meet strict standards beyond regional similarities or the mere sharing of an electronic health record, and must be integrating care in a manner that takes into consideration the quality of care to the patient population. This is important because clinical integration can be used to mask market consolidation efforts by hospital systems, when in fact there is no true integration of a patient\u2019s care. For example, saying that hospitals are regionally close or that hospitals are sharing electronic health records is not enough, there must be close coordination that will lead to less costly, higher quality care for local communities.<\/li>\n<\/ul>\n<p>Sutter is the largest hospital system in Northern California.\u00a0The\u00a0Sutter network\u00a0consists of some 24 acute care hospitals, 36 ambulatory surgery centers, and 16 cardiac and cancer centers.\u00a0It also includes\u00a0some 12,000 physicians and over 53,000 employees.\u00a0In addition, Sutter negotiates contracts on behalf of the Palo Alto Medical Foundation and many affiliated physician groups.<\/p>\n<p>A number of studies have shown how over-consolidation drives up prices for consumers. For example, a\u00a0<a href=\"http:\/\/petris.org\/wp-content\/uploads\/2018\/03\/CA-Consolidation-Full-Report_03.26.18.pdf\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=http:\/\/petris.org\/wp-content\/uploads\/2018\/03\/CA-Consolidation-Full-Report_03.26.18.pdf&amp;source=gmail&amp;ust=1615431121902000&amp;usg=AFQjCNGZ1kd68kG8wHXHkImvi19jkmLcpg\">University of California Berkeley report<\/a>\u00a0found that outpatient cardiology procedures in Southern California cost nearly $18,000 compared to almost $29,000 in Northern California. For inpatient hospital procedures, the cost in Southern California is nearly $132,000 compared to more than $223,000 in Northern California, a more than $90,000 difference. A\u00a0<a href=\"https:\/\/californiahealthline.org\/news\/if-you-want-to-spend-a-bundle-on-your-bundle-of-joy-go-to-northern-california\/\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/californiahealthline.org\/news\/if-you-want-to-spend-a-bundle-on-your-bundle-of-joy-go-to-northern-california\/&amp;source=gmail&amp;ust=1615431121902000&amp;usg=AFQjCNHhlsoG5XAdaaVlHyybp1CHzFQD5A\">2016 study<\/a>\u00a0found that a cesarean delivery in Sacramento, where Sutter is based, costs more than $27,000, nearly double what it costs in Los Angeles or New York, making Northern California one of the most expensive places in the country to have a baby.<\/p>\n<p>A copy of the\u00a0order granting preliminary\u00a0approval\u00a0is available\u00a0<a href=\"https:\/\/oag.ca.gov\/system\/files\/attachments\/press-docs\/Order%20Granting%20Preliminary%20Approval%20Sutter%2020210309%5B3%5D.pdf\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/oag.ca.gov\/system\/files\/attachments\/press-docs\/Order%2520Granting%2520Preliminary%2520Approval%2520Sutter%252020210309%255B3%255D.pdf&amp;source=gmail&amp;ust=1615431121902000&amp;usg=AFQjCNGhrkYrVTFjqy1L32L_9dIiObssBw\">here<\/a>.<\/p>\n<td colspan=\"2\" align=\"center\" bgcolor=\"#ffffff\" width=\"560\"># # #<\/td>\n","protected":false},"excerpt":{"rendered":"<p>Sacramento, CA&#8230;California Attorney General Xavier Becerra today applauded Judge Massullo\u2019s\u00a0preliminary approval of the groundbreaking settlement reached with Sutter Health (Sutter) in December 2019. The settlement\u00a0agreement\u00a0resolves allegations by the Attorney General, the United\u00a0Food and Commercial Workers International Union and Employers Benefit Trust\u00a0(UEBT),\u00a0and class action plaintiffs,\u00a0that Sutter\u2019s anticompetitive practices led to higher healthcare costs for consumers in [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":82791,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_cbd_carousel_blocks":"[]","jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[20,5,16,1],"tags":[],"class_list":["post-115954","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-featured","category-government","category-law-enforcement","category-news","last_archivepost"],"jetpack_featured_media_url":"https:\/\/new.thepinetree.net\/wp-content\/uploads\/2019\/07\/cadoj.jpg","jetpack_sharing_enabled":true,"jetpack-related-posts":[],"_links":{"self":[{"href":"https:\/\/new.thepinetree.net\/index.php?rest_route=\/wp\/v2\/posts\/115954","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/new.thepinetree.net\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/new.thepinetree.net\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/new.thepinetree.net\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/new.thepinetree.net\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=115954"}],"version-history":[{"count":0,"href":"https:\/\/new.thepinetree.net\/index.php?rest_route=\/wp\/v2\/posts\/115954\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/new.thepinetree.net\/index.php?rest_route=\/wp\/v2\/media\/82791"}],"wp:attachment":[{"href":"https:\/\/new.thepinetree.net\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=115954"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/new.thepinetree.net\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=115954"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/new.thepinetree.net\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=115954"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}