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[Sutter Case Watch] Court Approval of Final Settlement Concludes State Antitrust Action Against Sutter Health
Amy Y. Gu, Managing Editor August 30, 2021
See case page: UFCW & Employers Benefit Trust v. Sutter Health On August 27, nearly two years after the parties reached a proposed settlement agreement, Judge Anne-Christine Massullo of the San Francisco Superior gave the final approval to the settlement of the high profile antitrust case against Sutter Health. The final settlement was stalled several times along the way, first due to the coronavirus pandemic, then the court’s rejection of the compliance monitor, and most recently disputes over attorney fees, which was the subject of the preliminary approval hearing on July …
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Spotlight on State: Arizona
Hannah Park, Student Fellow August 25, 2021
This is part of a series of summaries that highlight notable legislation and initiatives in health policy and reform of all 50 states. Check back on The Source as we roll out additional states each week. See Arizona page. Arizona is active in promoting price transparency in health care. The state has some protections in place that address surprise billing for emergency services and services from out-of-network providers. This includes creating a solution for settling payment disputes between out-of-network providers and insurers by limiting patients’ liability and allowing for arbitration …
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Spotlight on State: Utah
Amy Y. Gu, Managing Editor August 20, 2021
This is part of a series of summaries that highlight notable legislation and initiatives in health policy and reform of all 50 states. Check back on The Source as we roll out additional states each week. See Utah page. Utah was one of the first states to operate an APCD, and claims to be the first to begin tracking and analyzing episodes of care, an important feature of risk-sharing based payment systems for states looking to reduce private payer and Medicaid expenditures. The state also enacted a right to shop …
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A Record Final Budget for California Brings Funding for Medi-Cal Expansion and the Office of Health Care Affordability
Mallory Warner, Health Policy Research Fellow August 18, 2021
California’s new fiscal year began on July 1 after the legislature approved a record state budget of $262.6 billion on June 28. The record budget was made possible by a $76 billion budget surplus and $27 billion in federal aid. This year’s budget process was especially confusing, as the California constitution requires the state legislature to pass a budget by June 15. This year, however, the legislature passed a placeholder budget on June 15 that allowed the state to spend the record sum, but the budget bill did not provide …
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Spotlight on State: Vermont
Amy Y. Gu, Managing Editor August 17, 2021
This is part of a series of summaries that highlight notable legislation and initiatives in health policy and reform of all 50 states. Check back on The Source as we roll out additional states each week. See Vermont page. Vermont has been active in cost containment and transparency through a number of state planning initiatives, rate and premium control, and the VHCURES all-payer claims database. Most notably, Vermont attempted to be the first state to operate a single-payer healthcare system, Green Mountain Care, in 2011; however, the state gave up on the …
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Cedars-Sinai/Huntington Cross-Market Affiliation Settle with Revised Competitive Impact Conditions
Amy Y. Gu, Managing Editor August 16, 2021
Healthcare entities have continued to actively pursue proposed mergers and affiliations during —and in part driven by— the coronavirus pandemic. Since the settlement of the Sutter Health antitrust lawsuit, the proposed affiliation of Cedars-Sinai Health System and Huntington Memorial Hospital in California has emerged as the leading case that has captured the attention of health policy experts as to its antitrust implications. The Source also weighed in on the case with an amicus brief filed with the Los Angeles County Superior Court. In this post, we further detail the background …
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Spotlight on State: Minnesota
Amy Y. Gu, Managing Editor August 12, 2021
This is part of a series of summaries that highlight notable legislation and initiatives in health policy and reform of all 50 states. Check back on The Source as we roll out additional states each week. See Minnesota page. Minnesota’s active legislative efforts aimed to increase healthcare price transparency and cost containment demonstrate the state’s commitment to improve its health care system. A leader in price transparency, the state has an active All-Payer Claims Database (APCD), which has been expanded to study cost, quality, and utilization. The state mandates that …
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North Carolina Class Action Sues HCA/Mission Health for Anticompetitive Contracting Practices
Amy Y. Gu, Managing Editor August 11, 2021
Breaking: A class action lawsuit has been filed in North Carolina state court against HCA Healthcare and Mission Health, alleging anticompetitive practices in violation of the North Carolina Constitution and antitrust and consumer protection laws. The lawsuit follows HCA’s 2019 acquisition of Mission Health in North Carolina, which was approved with conditions by the North Carolina AG, although none of which were competitive impact conditions. Plaintiffs, who are North Carolina patients, claim that Tennessee-based HCA used market power garnered from the cross-market merger to demand anticompetitive terms in contracts with …
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Updated: States with Certificate of Public Advantage (COPA) Laws
Amy Y. Gu, Managing Editor August 10, 2021
In the most recent legislative session, Indiana enacted a new certificate of public advantage (COPA) law (SB 416) that allows mergers of certain hospitals to receive immunity from claims of state antitrust laws for the duration of the certificate. Specifically, hospitals eligible for the COPA must be located in a predominately rural county with a specific population cap and has no more than two hospitals in the statewide comprehensive trauma care system. Indiana joins 17 other states with existing COPA laws and 1 states with limited COPA laws, mostly enacted …
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Biden’s Executive Order Reinvigorates Competition Policy
Katie Gudiksen, Senior Health Policy Researcher and Alex Montague, Amy Y. Gu, Jaime King August 5, 2021
This blog post is copublished with Milbank Memorial Fund. On July 9, 2021, President Biden issued an Executive Order on Promoting Competition in the American Economy, announcing his intent to reinvigorate antitrust enforcement throughout US industries with a special focus on certain markets including health care. The executive order and accompanying fact sheet cites research showing that hospitals in consolidated markets charge far higher prices than hospitals with several competitors and that hospital consolidation has left many areas, especially rural communities, without good options for convenient and affordable health care …
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