Legal Challenges Against State PBM Laws May Culminate in Supreme Court Review
Amy Y. Gu, Managing Editor November 15, 2019
As states step up their efforts to control prescription drug prices, many state legislatures have targeted pharmacy benefit managers (PBMs) and their role in rising prices by introducing legislation to bring greater transparency to the inner workings of PBMs. As a result of these efforts, however, states increasingly face challenges from the pharmaceutical industry, specifically the Pharmaceutical Care Management Association (PCMA), a trade association representing PBMs. Over the years, PCMA has brought a number of lawsuits challenging state legislation regulating PBMs, claiming that the Employee Retirement Income Security Act (ERISA) …
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The Source Roundup: November 2019 Edition
Ada Shao, Student Fellow November 1, 2019
Happy November! If you’re wondering what to do with that extra hour as Daylight Savings ends, why not peruse the latest in healthcare news? In this month’s Source Roundup, we look at articles that analyze 1) the role of waste and prescription drug prices in increasing healthcare costs, 2) the impact of market concentration and competition in healthcare pricing, and 3) the projected impact of healthcare reform proposals. Healthcare Spending Increases Due to Waste and Rising Prescription Drug Costs As Americans dig deeper into their pockets to pay for …
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SB 343: The Importance of Aligning Kaiser’s Disclosure Requirements with Other Insurers and Hospitals
Sammy Chang, Health Policy Researcher November 1, 2019
To lower health care costs, transparency is critical. The recently approved SB 343 is California’s next step toward greater price transparency. This bill would require Kaiser Permanente to report the same amount and type of information as any other hospital and health plan would. This change underscores a new reality: while Kaiser may be structurally different from its competitors, its premiums are similarly priced. Because Kaiser covers nearly two thirds of the large group market enrollees (i.e. employers with more than fifty employees), SB 343 fills an important data gap …
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[Sutter Case Watch] Source Executive Editor Jaime King Discusses Sutter Health Settlement in Podcast
Amy Y. Gu, Managing Editor October 30, 2019
See UFCW & Employers Benefit Trust v. Sutter Health case page. As the healthcare industry grapples with the recent settlement of the antitrust case against Sutter Health, The Source Executive Editor Jaime King discusses the possible motivations and implications of this development in Tradeoffs, a healthcare podcast. In Episode 2 of the podcast, The Train Has Left the Station, Professor King points out that because Sutter is a model for many other health systems around the country, the lawsuit against Sutter’s contracting practices, including all or nothing provisions, had …
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[Sutter Case Watch] BREAKING: Sutter Health Settles Massive Antitrust Suit to Avoid Trial
Amy Y. Gu, Managing Editor October 16, 2019
See UFCW & Employers Benefit Trust v. Sutter Health case page. The historic court case against Sutter Health alleging anticompetitive contract practices took an unexpected turn today when Judge Anne-Christine Massullo of the Superior Court of San Francisco dismissed the jury, announcing that Sutter has reached a preliminary settlement with the California AG and class action plaintiffs. Opening arguments in the case were set for October 21, after it was delayed from October 10 due to an insufficient number of jurors. The trial was estimated to last about 12 weeks and …
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[Sutter Case Watch] BREAKING: Sutter Trial Delayed Due to Jury Trouble
Source Fellow October 10, 2019
See UFCW & Employers Benefit Trust v. Sutter Health case page. Updated 10/11/19: Start of Trial further delayed to Monday, October 21 per 10/11 hearing regarding jury selection. By: Alex Montague, Graduate Research Fellow Opening arguments for the antitrust case against Sutter Health, set to begin Oct 10 at 10:15am in the Superior Court of San Francisco, were postponed today after the court expressed concern that there was an insufficient number of jurors available to move forward for the trial. Several jurors were absent for today’s trial due to medical conditions …
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[Case Watch] Jury Trial in Antitrust Case Against Sutter Health Set to Begin
Amy Y. Gu, Managing Editor October 9, 2019
See UFCW & Employers Benefit Trust v. Sutter Health case page. The landmark antitrust case against Sutter Health, the largest provider of general acute hospital services in Northern California, is set to begin jury trial in the Superior Court of San Francisco on October 10 and is expected to last 12 weeks. The trial will begin at 10:15am with opening arguments from both parties. The Source has been closely tracking this case leading up to the trial. Executive Editor Jaime King was quoted in multiple news outlets, including the New York …
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[In the Press] Interview Quoted in San Francisco Chronicle Article “Antitrust case against Sutter Health due to begin this week”
Jaime S. King, Executive Editor October 8, 2019
Jaime King was quoted in the 10/8/2019 San Francisco Chronicle article “Antitrust case against Sutter Health due to begin this week”.
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[Case Watch] UCFW & Employers Benefit Trust v. Sutter Health] A Look at the Legal Arguments Through the Lens of the Court’s Denial of Sutter’s Motions for Summary Judgment
Amy Y. Gu, Managing Editor October 7, 2019
See UFCW & Employers Benefit Trust v. Sutter Health case page. As part of the Case Watch series for the landmark antitrust suit against Sutter Health, this post takes a look back at the Superior Court of San Francisco’s orders from March and June 2019, denying Sutter’s motions for summary judgment, which set the stage for the jury trial, set to begin on Thursday, October 10, 2019. As a preview of the legal arguments we will see at trial, we dissect each of the four causes of action brought against Sutter …
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[In the Press] Interview Quoted in New York Times Article “High Medical Bills Are at Center of Hospital Group’s Trial”
Jaime S. King, Executive Editor October 3, 2019
Jaime King was quoted in the 10/3/2019 New York Times article High Medical Bills Are at Center of Hospital Group’s Trial: Jaime King, a law professor at U.C. Hastings College of the Law, described the approach as “a landmark case.” Rather than trying to block a merger over antitrust concerns, the Sutter trial is an attempt to attack the practices of a powerful hospital system. “The Sutter case is challenging a whole system of behavior,” she said.
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