About
About this Settlement Compliance Monitorship Website
On April 7, 2014, UFCW & Employers Benefit Trust (“UEBT”) filed a lawsuit as a proposed class action against Defendants, Sutter Health (“Sutter”) and certain affiliates identified below1, in the Superior Court of California, County of San Francisco. The California Attorney General filed a nearly identical lawsuit in the same Court on March 29, 2018, and the two cases were consolidated on May 8, 2018. The Honorable Anne-Christine Massullo is the Judge overseeing this case.
In short, the Plaintiffs in this case alleged that Defendants violated the Cartwright Act (California’s antitrust law) and California’s Unfair Competition Law. Plaintiffs alleged, among other things, that Defendants engaged in practices and included provisions in their contracts with the major health insurance companies in California that restricted price competition between Defendants and other general acute care hospitals and other providers in Northern California. Plaintiffs alleged that these practices led to a reduction in price competition which permitted Defendants to overcharge self-funded payors for Defendants’ general acute care hospital services and ancillary products. Defendants deny that they did anything wrong and deny that Plaintiffs and the Class are entitled to receive any money or other relief from Defendants.
On August 14, 2017, the Court certified UEBT’s lawsuit as a class action and authorized Plaintiff UEBT to represent a Class of self-funded payors. See FAQs for more information on how the Class is defined.
On December 17, 2019, UEBT and the California Attorney General entered into a Settlement Agreement with Defendants. On August 27, 2021, the Court approved the Settlement Agreement, which provides, in part, for payment of $575 million as a global settlement fund (the “Settlement Fund”) to resolve the Class’s damages claims and the California Attorney General’s disgorgement claim from which fees and costs may be awarded to all Plaintiffs’ Counsel for their work on the claims in this action. The Settlement Agreement also provides for injunctive relief against Defendants. That injunctive relief is explained in the Final Judgment and Order (the “Final Judgment”), which is attached to the Settlement Agreement.
In sum, the Final Judgment provides for an injunction that prohibits and permits certain conduct related to Defendants’ contracting practices with insurance companies concerning network participation, steering, tiering, out-of-network pricing, new affiliate pricing, and availability of pricing information. The injunction lasts for 10 years with the possibility of a 3-year extension if requested by Plaintiffs and approved by the Court.
As part of the Final Judgment, Dionne Lomax of Affiliated Monitors, Inc. (“AMI”) was appointed to serve as the Compliance Monitor (the “Compliance Monitor” or the “Monitor”) to monitor Defendants’ compliance with the Final Judgment. In monitoring compliance with the Final Judgment, the Monitor has certain enumerated powers, including the power to take complaints from “Plaintiff(s)” and “Insurers” (as those terms are defined in the FAQS) regarding Sutter’s compliance with the Final Judgment.
This website has been established by AMI for “Plaintiff(s)” and “Insurers” to submit a complaint alleging that Sutter is not in compliance with the Final Judgment, which is available for review here.
For more information about the lawsuit and the Settlement Agreement, see this website.