Sutter Health Claims It Doesn’t Have Market Power As Antitrust Trial Begins

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Because of that, attorney Jeffrey LeVee said, "it cannot violate the antitrust laws." Modern Healthcare reports that opening statements in the case focused on the dispute over whether not-for-profit Sutter requires health plans to contract with all its hospitals as a condition of contracting with one of them, a practice known as "tying."

Modern Healthcare: Sutter Health Argues It Doesn't Have Market Power, Can't Violate Antitrust Laws Sutter Health on Thursday attempted to shake off federal antitrust allegations by arguing that the 24-hospital system doesn't have market power in the Northern California region it serves. Sutter Health's attorney Jeffrey LeVee, a Jones Day partner who gave Sutter's opening statement as the trial kicked off, claimed that the $13 billion organization faces "vigorous competition," particularly from a larger California health system, Kaiser Permanente. (Bannow, 2/10)

AP: 3 Million Plaintiffs Seek $1.2B From California Health Firm A lawsuit over high health care bills filed on behalf of more than 3 million employers and people seeks as much as $1.2 billion from a large Northern California health system in an antitrust class-action trial getting underway Thursday. Plaintiffs in the lawsuit allege in court documents that Sutter Health abused its market power and “caused enormous adverse economic impacts” by discouraging patients from using lower-cost insurance and lower-cost hospitals. (Thompson, 2/10)

In other health care industry news —

WUSF Public Media: Nurses Union Accuses HCA Of Unnecessary Hospital Admissions To Drive Profits A report from the nation’s largest nurses union accuses HCA Healthcare of over admitting emergency room patients into its hospitals to increase profits. The report from the Service Employees International Union analyzed national Medicare data and found that hospitals run by HCA had an emergency department admission rate in 2019 that was 5% higher than the national average. In Florida, HCA’s emergency room admission rate in 2019 was 41%, compared to 38% for all other hospitals. “This possibly illegal, unethical patient care practice pads HCA’s pockets by costing taxpayers and consumers billions in reimbursement for unnecessary procedures and services, while also exposing patients to unnecessary risk,” the report says. (Bruner, 2/10)

Dallas Morning News: North Texas Medical Labs, Doctors Charged In Health Care Fraud Scheme, Billing Over $300 Million Three North Texas laboratory companies are charged with participating in a bribery scheme where doctors were offered kickbacks to order millions of dollars worth of unnecessary tests. The scheme resulted in over $300 million being billed to federal health care programs, like Medicare, according to a federal indictment. Two doctors and eight others are accused of health care fraud in the indictment after several federal offices, including the FBI Dallas field office, investigated the case, the U.S. Attorney’s Office for the Northern District of Texas announced Thursday. (Jones, 2/10)

Los Angeles Times: Health Spa Owner Pleads Guilty To $20-Million Fraud Scheme The former owner of a group of health spas and clinics in the San Fernando Valley pleaded guilty Tuesday to her role in a $20-million healthcare fraud scheme that involved Botox injections and laser hair removal, according to federal investigators. Patients at the health spas and clinics were asked to hand over their insurance information, even though the staff and owner knew the cosmetic procedures would not be covered by the patients’ insurance providers. (Solis, 2/9)

Chicago Tribune: $6.75M Malpractice Settlement Eyed Against Cook County Hospital Cook County commissioners are set this week to finalize a $6.75 million settlement to a former patient of Stroger Hospital who alleges in a lawsuit that she was left paralyzed because doctors failed to treat a spinal condition. The pending medical malpractice settlement sailed through the Cook County Board’s Finance Committee Wednesday in a 17-0 vote and now heads to a final floor vote on Thursday. The plaintiff, Zertasha Williams, alleges she has now chronic pain and incontinence and must use a wheelchair because of negligence from the Stroger staff, according to a copy of the suit filed in Cook County Circuit Court. (Yin, 2/9)

Also —

Houston Chronicle: Over 6,000 Memorial Hermann Patients Could Be Affected By Security Incident More than 6,000 Memorial Hermann patients could be affected by a security incident involving one of the health system’s vendors, Advent Health Partners, according to the health system. Advent Health Partners said in a statement it “detected suspicious activity on employee email accounts involving data provided to Advent Health Partners” in September 2021, and the company started an investigation into the issue. “While the investigation is ongoing, on December 2, 2021, Advent Health Partners determined that certain files containing information of individuals were potentially accessed by an unauthorized third party,” Advent Health Partners’ statement read. “Advent Health Partners started providing notice of this incident on January 6, 2022.” (Brennan, 2/9)

The CT Mirror: Yale New Haven Health To Acquire Three Hospitals In Central CT Yale New Haven Health is looking to add three hospitals to its network, the latest in an ongoing spate of consolidation in the state’s acute care sector. The New Haven-based health system, the state’s largest by revenue, said Thursday it had signed an agreement with Los Angeles-based Prospect Medical Holdings to acquire its three Connecticut-based hospitals: Waterbury Hospital, Manchester Memorial Hospital and Rockville General Hospital. The deal would add more than 700 beds to the roughly 2,700 YNHH currently maintains. (Phillips and Golvala, 2/10)

Modern Healthcare: Sentara Healthcare To Invest $125 Million To Attract, Retain Workers Sentara Healthcare on Thursday said it would spend $110 million on raises and $15 million more on benefits for workers this year. The Norfolk, Virginia-based health system will give eligible employees a 5% wage increase starting March 17 and will offer merit raises in May, the company said in a news release. The combined raises will affect more than 96% of the 29,000-person workforce. (Christ, 2/10)

Patients with sepsis who are discharged from emergency departments appear not to have adverse outcomes, but doctors overseeing their care could benefit from uniform guidelines for those decisions, according to a study published in JAMA Network Open on Thursday. Researchers led by Dr. Ithan Peltan of the University of Utah School of Medicine and Salt Lake City-based Intermountain Healthcare reviewed the characteristics of people with sepsis discharged from emergency departments, which hasn't been vigorously researched before. The team reviewed electronic health records data from four Intermountain Healthcare hospitals in Utah along with state and federal death records. (Gillespie, 2/10)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

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