Category: News Feeds

Sutter Health will pay $575 million to settle allegations that the Sacramento-based health system engaged in anticompetitive practices that led to higher costs for patients.

One of Northern California’s largest health systems, Sutter Health employs roughly 12,000 physicians, and has 24 hospitals and 36 surgery centers in its network.

Though the California Attorney General and Sutter Health previously announced the settlement in October, they did not disclose the terms until Dec. 20. If approved by the court, the sweeping terms of the settlement may set a tone for other large health systems across the state.

“This first-in-the-nation comprehensive settlement should send a clear message to the markets: if you’re looking to consolidate for any reason other than efficiency that delivers better quality for a lower price, think again,” California Attorney General Xavier Becerra said in a news release.

Per the terms, Sutter Health must pay $575 million to cover class action compensation and legal costs. The health system must also cease all-or-nothing contracting deals with payers, limit what it charges for out-of-network services, work with a court-approved compliance monitor for at least 10 years, and must allow insurers to provide plan members with information on pricing, quality and cost. The nonprofit must also meet clearly set definitions of clinical integration, meaning “…it must meet strict standards beyond regional similarities or the mere sharing of an electronic health record, and must be integrating care in a manner that takes into consideration the quality of care to the patient population,” according to the settlement.

Flo De Benedetto, Sutter Health’s general counsel, said in a statement that the organization was “committed to keeping our care connected so patients continue to receive affordable, high-quality, personalized and coordinated care. Despite the increasing cost of care and operating in high-wage markets, we remain focused on making healthcare more affordable for our patients.

“We were able to resolve this matter in a way that enables Sutter Health to maintain our integrated network and ability to provide patients with access to affordable, high-quality care. Together with the Attorney General, the parties selected an experienced monitor who will oversee the agreement, which specifies parameters for contracting between Sutter Health and insurance companies going forward,” Di Benedetto stated.

In the future, Sutter Health will have to evaluate future capital investments based on the impact of the settlement, she added. According to Sutter Health’s unaudited financial statements, the nonprofit finished the quarter ending Sept. 30 with an operating loss of $613 million, down from a net profit of $49 million during the third quarter last year.

The suit, originally brought against Sutter Health by the United Food and Commercial Workers International Union and Employers Benefit Trust in 2014, alleged that Sutter Health used its market dominance to prevent insurers from carving out narrower networks that would exclude some of its facilities. The case was later consolidated with a separate lawsuit filed by California Attorney General Xavier Becerra in 2018.

According to the complaint, Sutter Health acquired significant market concentration after its acquisition of Summit Medical Center in 2000.  The California Attorney General’s complaint alleged that shortly after, Sutter Health began bundling together its providers, requiring payers to contract for them on a system-wide basis.

Sutter also allegedly used other measures to prevent the formation of narrow networks that might exclude some of its providers, including high out-of-network costs and provisions that restricted health plans from putting its providers in any tier other than the most favored benefit tier. The health system also used confidentiality provisions that restricted health plans’ ability to provide comparisons about price and quality to plan members, according to the complaint.

The settlement must be approved by the court before it goes into effect, with a hearing set for Feb. 25.

Photo credit:  zimmytws, Getty Images 

HARARE – Last week, the United Nations World Food Programme (WFP) in Zimbabwe completed its last cash distribution of 2019, which supported some 19,000 vulnerable residents in Harare’s suburban district of Epworth.

Those deemed most food insecure have been receiving monthly cash transfers from WFP since June, as part of an urban pilot project funded by the UK’s Department for International Development (DFID), and the EU’s branch of European Civil Protection and Humanitarian Aid Operations (ECHO).
This year was the first time WFP provided assistance to an urban area in Zimbabwe.

Next year, WFP will expand its urban assistance programme across eight districts, nationwide. It will continue providing cash-based transfers on a monthly basis, to those who need it most.

s a result of this year’s severe drought, economic downturn and Cyclone Idai, around 8 million people were pushed into severe hunger. Of this total, 2.2 million people live in urban areas. WFP’s revised emergency response plan hopes to provide mobile cash transfers to 200,000 of them. Currently, funding for 100,000 has been secured. WFP is seeking funds to assist an additional 100,000 people.

Post published in: Featured

When I was growing up, I figured out a helpful thought exercise to put things in perspective. First, think of the worst possible outcome from any situation. The worst possible outcome usually, by definition, involves nuclear war or a pandemic. As a kid, these worst-case scenarios usually involved the Cold War turning hot, finally using all those nuclear drills we learned in school, and later Saddam Hussein.

Second, think on that worst outcome for a little while until you come to terms with it. Obviously a world-ending catastrophe would be very bad, but the whole thing is really out of your control and, once it happens, either it’s going to be all over quickly or you’re just going to have to adjust to your radically new circumstances. If you are one of the survivors, dwelling over the fragility of our lost civilization is just going to make things worse. Instead, you’re just going to need to accept things and get on with it.

Third, use this newfound viewpoint to give new perspective to whatever current situation you’re dealing with. Usually the absolute worst realistic bad outcome from whatever you’re facing — be it a test as a student or some brief as a lawyer — is that you end up spending the rest of your life homeless and disgraced and living in a cardboard box under a bridge. Compared against dying slowly of radiation poisoning after being responsible for the downfall of civilization, that’s not too bad. And the more realistic worse-case scenario, as a student or a lawyer, usually is that someone yells at you.

Lawyers too often worry in a way that either paralyzes them or caused them to act rashly and make bad decisions. Don’t let it happen to you.

Don’t Worry In A Nonproductive Way

Of course, you need to carefully calibrate any worries to maximize your performance and edge. The goal is always to convince yourself that failure has disastrous consequences — a single typo in a brief should haunt you for years — but you must carefully balance such thoughts so that they only positively affect your performance. Any fears that negatively affect your performance must be banished.

Since law tends to attract the pathologically risk averse, many lawyers allow nonproductive fears to influence their actions. But that is bad.

Keep Things In Perspective

Instead, you should use the three-part thought exercise to keep fears in perspective and act accordingly. No matter what you’re facing, unproductive anxiety will only make it worse. Even when the stakes are high, a blind panic never makes it better.

Indeed, no matter how high the stakes, usually small errors can be corrected by subsequent acts. Even when they can’t, the worst-case scenario is usually the rest of your life living in a cardboard box — or sometimes prison, depending on the circumstances — and a blind panic will only bring you closer to that result.

Keep Calm And Carry On

So whatever you do or face, don’t panic. Instead, keep a calm, balanced demeanor as you pursue whatever task you are pursuing. No matter what, it will result in a better outcome than blindly worrying about what will happen. Buckle down, stop freaking out, and get on with it.

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Matthew W. Schmidt has represented and counseled clients at all stages of litigation and in numerous matters including insider trading, fiduciary duty, antitrust law, and civil RICO. He is a partner at the trial and investigations law firm Balestriere Fariello in New York, where he and his colleagues represent domestic and international clients in litigation, arbitration, appeals, and investigations. You can reach him by email at matthew.w.schmidt@balestrierefariello.com.

We’ve talked about military spouses and the struggles of maintaining a legal career when moving states (or countries) every few years. While we’ve highlighted some of the innovative solutions out there for spouse attorneys — like robust, tech-assisted freelancing — the simplest solution would be for states to just lighten up on the licensing bureaucracy to help those stationed domestically port their careers.

The latest National Defense Authorization Act includes a provision calling on the Department of Defense to take steps to convince the states to harmonize a bit for the good of military spouses.

The NDAA provision calls for the DoD to enter an agreement with the nonprofit Council on State Governments to come up with a series of proposed interstate compacts to ease licensing restrictions. The goal is to “alleviate the burden associated with relicensing in such an occupation by a spouse of a member of the armed forces in connection with a permanent change of duty station,” according to the legislation.

That unfortunately feels like throwing another committee at the problem, but what are you going do? The government’s throwing up to $4 million toward the project.

New Law Will Make It Easier for Military Spouses to Keep Licenses During a PCS [Military.com]

Earlier: Making The Profession Work For Military Spouses

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Joe Patrice is a senior editor at Above the Law and co-host of Thinking Like A Lawyer. Feel free to email any tips, questions, or comments. Follow him on Twitter if you’re interested in law, politics, and a healthy dose of college sports news. Joe also serves as a Managing Director at RPN Executive Search.

Another stupid, pointless effort to turn protectors and servants into professional victims is being mounted in Alabama. Cops can barely be bothered to educate themselves on the laws they’re enforcing, but they’re usually all over the ones that allow them to turn things they don’t like into criminal activity.

It’s (yet another) “blue lives matter” law being foisted upon citizens by legislators who are altogether too certain they’re in the right. Here’s the backer of the proposed law that would turn cops into a protected group making a claim that’s proven false before the end of the article at PoliceOne.

“Everyone agrees that it should be a hate crime to shoot a police officer,” said state Sen. Cam Ward, R-Alabaster, and chairman of the Alabama State Senate Judiciary Committee where the hate crime legislation is reviewed. “I don’t know anyone who opposes that. The question is, ‘What gets tacked on?’ Yes, you can find a bipartisan solution.”

Everyone?

[Sen. Vivian] Figures said she favors “of doing everything we can to protect our law enforcement officials.” But she said she’s unsure if a hate crime law is the right vehicle.

The bill, written by Senator Chris Elliott, is his second attempt to push a cop-friendly hate crime bill through the legislature. Elliott possibly figures he’ll have a better chance this year because more cops have been killed in Alabama than usual. There have been six law enforcement officers killed by residents this year, which puts the state towards the top of the killed in the line of duty list.

The senator who spoke for everyone (while being wrong about what “everyone” agreed with) doesn’t want this bill tainted with riders that would provide similar hate crime protections for others more deserving of these protections. Sen. Figures (who does not agree with Ward’s assertion that “everyone agrees”) may have been responsible for the death of Elliott’s previous effort when she added an LGBTQ amendment to his 2018 “blue lives matter” bill. That’s the sort of “tacking on” Ward is hoping to prevent here, in order to give cops more protections while leaving more vulnerable residents less protected.

Adding to the stupidity is the fact that police already benefit from a law that provides an extra deterrent to killing cops.

In Alabama, killing a law enforcement while they are on the line of duty is an aggravating factor that is punishable by the death penalty.

These proposals have made periodic appearances in the years following the shooting of Michael Brown in Ferguson, Missouri. The shooting was a flash point in police-community relationships. With the current federal administration strongly pro-law enforcement, state-level legislators perhaps feel emboldened to pursue legislation that does little to protect cops, but everything to put more distance between law enforcement and the people they serve.

These proposals are reactionary in the worst sense of the word. They’re legislative affirmations that might makes right and the people with most might will continue to consolidate power. There’s little evidence that suggests these laws are justified at any level. Most killings of cops are impromptu, not planned assaults inspired by an insatiable hate for law enforcement.

The general public receives zero benefit from these laws. All that happens is a very well-protected group of government employees gets even more protections. The laws become vehicles for abuse and there’s only so much courts can do to protect citizens if their “representatives” decide to serve fellow government employees rather than their constituents.

The upside here is these proposals — at least here in Alabama — can be neutralized by adding amendments that would extend protections to people who don’t wear the blue — especially members of the public that far too many legislators don’t feel are worthy of any protection.

Alabama Lawmakers Think The Time Is Right To Make Assaulting A Cop A ‘Hate Crime’

More Law-Related Stories From Techdirt:

Federal Court Blocks Unconstitutional Arkansas Law That Prevents Plant-Based Food Companies From Using Meat Words
Austrian Hotel Drops Libel Lawsuit Against Guest Who Complained About Pictures Of Nazis In The Lobby
Dear Americans: Be Very, Very Afraid Of The EU’s New Copyright Rules

The hedge fund he founded, named for himself and led for 24 years—including through a damaging bribery scandal—isn’t doing so well, thanks to said bribery scandal (and is also no longer named for him and possibly no longer returning his calls). Dan Och, though? Yea, Dan Och is doing fine.

Mr. Och paid roughly $95 million for the penthouse unit as well as a smaller unit on a lower floor of the building, located at 220 Central Park South…. Mr. Och’s new four-bedroom apartment spans about 9,800 square feet, according to marketing materials for the property.

* Brush of your resumes everyone, a longtime general counsel of Boeing is going to retire by the end of the year. [Wall Street Journal]

* A UK lawyer is under fire for claiming he killed a fox with a baseball bat. Lawyers need to learn to stop being cruel to animals. [New York Post]

* A rapper currently serving time in prison has donated a significant amount of cheddar to his lawyer’s synagogue. Such a mitzvah. [Jewish Telegraphic Agency]

* Chief Justice Roberts is going to have a pivotal role in any upcoming impeachment trial. [AP]

* The Washington Supreme Court has held that drivers need to use the turn signal every time they move their car into a different lane of traffic. This kind of makes sense, but try telling this to New Jersey drivers… [Seattle Times]

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Jordan Rothman is a partner of The Rothman Law Firm, a full-service New York and New Jersey law firm. He is also the founder of Student Debt Diaries, a website discussing how he paid off his student loans. You can reach Jordan through email at jordan@rothmanlawyer.com.

Businessman Frank Buyanga. Photo: Supplied