The high-profile antitrust case against Sutter Health settled on the eve of trial in October 2019, when the Northern California hospital giant reached a preliminary settlement agreement with the California Attorney General’s office and class action plaintiffs after five years of litigation. The terms of the settlement were released late December, which include both monetary compensation for the private plaintiffs and injunctions against Sutter’s conduct that will restore competition and promote transparency in the provider market. In this post, we dissect the terms of the proposed settlement agreement and discuss …

On January 10, the Department of Justice (DOJ), along with the Federal Trade Commission (FTC), released a new draft guideline for vertical merger review. As opposed to horizontal mergers, vertical mergers generally combine entities that operate at different levels in the same supply chain. As vertical mergers become more commonplace in the healthcare industry, they are increasingly raising antitrust concerns as they often times don’t trigger the same level of scrutiny as do horizontal mergers. The much needed new guidelines specifically targeting vertical mergers serve to withdraw and update the …

Today, California Attorney General Xavier Becerra announced the settlement terms for the landmark antitrust case, UFCW & Employers Benefit Trust v. Sutter Health. Sutter Health was alleged to engage in anticompetitive behavior by requiring “all or nothing” contracts, preventing insurance companies from providing tiered health plans, setting extremely high out-of-network rates, and restricting price transparency of provider cost information and rates. As Source Executive Editor Jaime King explains in a Tradeoffs episode, The Train Has Left the Station, “[t]his is a huge case. Sutter is a huge entity in Northern …

Price transparency in healthcare is a hot topic that has captured the attention of many policymakers. While both federal and state governments have made efforts to promote price transparency in recent years, the path to achieving it is expected to be a bumpy one, as powerful industry groups that resist such change, including hospitals and pharmaceutical companies, are quick to seek legal challenges to block such efforts. In this edition of Litigation and Enforcement Highlights, we examine the latest lawsuits that challenge legislation to promote price transparency in healthcare and …

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) …

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 the potential to send shockwaves through the system. The actual implications of …

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 would have put the spotlight on the details of Sutter …

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 and various other reasons, with several more expressing that they …

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 Times, San Francisco Chronicle, and Bloomberg Law, regarding the ripple …

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 in the context of Sutter’s motions and the court’s rulings. …