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[Sutter Case Watch] Sutter Health Preliminary Approval of Settlement Agreement Held up by Compliance Monitor Selection
Amy Y. Gu, Managing Editor August 13, 2020
See case page: UFCW & Employers Benefit Trust v. Sutter Health After much delay due to the pandemic induced hiatus, the preliminary approval hearing for the proposed settlement agreement in the Sutter Health antitrust case resumed on August 12 at the Superior Court of San Francisco. At the hearing, plaintiff attorneys on behalf of both class members UEBT and the Attorney General addressed in turn questions with respect to specific proposed terms raised in a tentative ruling by Judge Anne-Christine Massullo.[1] One key issue the court rested on was the selection …
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Surprise Billing: Proposed Federal Solutions From Both Sides of the Aisle
Source Fellow August 11, 2020
By: Danika Rothwell, Student Fellow Paul DeWolfe needed back surgery. He knew the operation would be covered by his insurance and was careful to make sure the hospital he chose was in his insurer’s network. DeWolfe sat down and did the math. He figured his portion of the bill would cost roughly $3,000. When DeWolfe recovered from his procedure, he was shocked to receive a bill for $18,590.83.[1] Despite all his attentive preparation, some of the physicians who treated him at his in-network hospital were, in fact, out-of-network. This story …
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The Source Roundup: August 2020 Edition
Kendall Kohlmeyer, Student Fellow August 3, 2020
The Source continues to extend wishes of safety and good health to you and your loved ones. This month, some policy and market considerations reflect on the Affordable Care Act in its tenth year, while others continue to focus on the COVID-19 pandemic and its projected long-lasting effects. Many experts share how and why the pandemic urgently necessitates healthcare system reform in the United States. The Affordable Care Act Last month, the Duke University Press Journal of Health Politics, Policy and Law published The Affordable Care Act’s Missing Consensus: …
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[In the Press] Interview Quoted in New Times San Luis Obispo Article
Jaime S. King, Executive Editor July 30, 2020
Executive Editor Jaime King was quoted in the 7/30/2020 New Times San Luis Obispo article Big health: A look at how the Central Coast’s two hospital systems shape local health care costs: “The data is incredibly clear on this,” said Jaime King, a professor at UC Hastings College of Law who specializes in health care markets and policy. “Hospital mergers result in significant price increases almost immediately. Both entities’ prices go up as a result. Neighboring hospitals’ prices go up, too, as a shadow effect. It’s having an even bigger effect …
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[Presentation] Nevada Patient Protection Commission Meeting
Jaime S. King, Executive Editor July 20, 2020
The Nevada Patient Protection Commission Presentation on drivers of healthcare costs and efforts to improve transparency in healthcare pricing Presentation: “Addressing High Health Care Prices: Transparency, Enforcement, and Legislation” Meeting Recording Meeting Minutes
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The California Budget During the COVID-19 Pandemic: A Balancing Act
Mallory Warner, Health Policy Research Fellow July 15, 2020
The world in January was a very different place than the world today. The effects of the pandemic-induced recession are clearly reflected in the California budget. In January, California was projected to have a surplus of $5.6 billion. By the Governor’s May Revision, however, the state was facing an estimated deficit of $54.3 billion.[1] The difference of $60 billion in four short months was created by the COVID-19 crisis. As a result, legislative priorities from the beginning of the year inevitably shifted, as the Assembly and Senate approved a $202.1 …
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[Sutter Case Watch] Approval Hearing of Sutter Health Settlement Moves Forward Despite COVID-19
Amy Y. Gu, Managing Editor July 10, 2020
See case page: UFCW & Employers Benefit Trust v. Sutter Health At a July 9 hearing at the Superior Court of San Francisco, Judge Anne-Christine Massullo denied Sutter Health’s motion to delay the approval hearing of the preliminary settlement agreement due to the COVID-19 pandemic. This is an encouraging ruling as there was much speculation and concern that Sutter’s request is a thinly veiled attempt to walk back the historic settlement reached last December amidst the chaos of COVID-19. In a California Healthline quote last month, The Source Executive Editor …
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Final DOJ and FTC Vertical Merger Review Guidelines Fail to Impress
Amy Y. Gu, Managing Editor July 9, 2020
After much anticipation and a round of public comments on the draft guidelines released in January, the Department of Justice (DOJ), along with the Federal Trade Commission (FTC), officially issued the final Vertical Merger Review Guidelines, replacing the Non-Horizontal Merger Guidelines originally issued in 1984. The updated guidelines govern how federal antitrust agencies evaluate vertical, as well as other non-horizontal mergers. The guidelines outline three main sources of evidence for potential adverse competitive effects from vertical mergers: 1) Foreclosure and Raising Rivals’ Costs, 2) Access to Competitively Sensitive Information, and …
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The Source Roundup: July 2020 Edition
Kendall Kohlmeyer, Student Fellow July 1, 2020
The Source continues to extend wishes of safety and good health to you and your loved ones. As the pandemic causes the healthcare industry financial tragedy, health law experts share important considerations for policymakers, providers, and payers. Many authors hope the pandemic will effect much-needed lasting improvements in the efficiency and efficacy of health care in the U.S. Antitrust Experts Recommend More Rigorous Regulation of Healthcare Consolidation In Preventing Anticompetitive Healthcare Consolidation: Lessons from Five States, published by the Source on Healthcare Price & Competition, authors Jaime King, et …
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Federal Telehealth Waivers Provide Flexibility During the COVID-19 Crisis to Expand Coverage and Access to Healthcare
Source Fellow June 30, 2020
By: Megan Pham, Student Fellow COVID-19 has upended the way individuals across the country access medical care and has made doctors’ offices and hospitals high-risk grounds for transmission. This leaves the elderly and immunocompromised who seek care especially vulnerable. In response, the U.S. Department of Human and Health Services (HHS) and Centers for Medicare and Medicaid Services (CMS) have adopted a series of waivers to allow increased access to and coverage of healthcare services through telehealth. PRE-PANDEMIC TELEHEALTH Telehealth is “the use of telecommunications and information technology to …
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