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Who is the Compliance Monitor and what is their role?

Under the terms of the Final Judgment and Order (the “Final Judgment”) entered in the lawsuit UFCW & Employers Benefit Trust, et al. v. Sutter Health, et al., Case No. CGC-14-538451 consolidated with CGC-18-565398, a Compliance Monitor has been appointed to monitor Sutter Health’s compliance with the injunctive terms of the Final Judgment. Dionne Lomax of Affiliated Monitors, Inc. has been appointed the Compliance Monitor by the Judge in this case. As part of her monitoring activities, Ms. Lomax has the responsibility for accepting and investigating complaints alleging that Sutter Health is not complying with the terms of the Final Judgment and making recommendations to the Court regarding these complaints. For more information on the Compliance Monitor and the lawsuit UFCW & Employers Benefit Trust, et al. v. Sutter Health, et al. and why this website was established, please see the About section of the website.

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Why is there a website to submit complaints about Sutter Health?

This website was established by Affiliated Monitors, Inc. for the submission of complaints about Sutter Health’s compliance with the terms of the Final Judgment and Order (the “Final Judgment”) entered in the lawsuit UFCW & Employers Benefit Trust, et al. v. Sutter Health, et al., Case No. CGC-14-538451 consolidated with CGC-18-565398. For more information on the lawsuit UFCW & Employers Benefit Trust, et al. v. Sutter Health, et al. and why this website was established, please see the About section of the website.

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What is the Final Judgment entered in the lawsuit UFCW & Employers Benefit Trust, et al. v. Sutter Health, et al.?

The Final Judgment prohibits and permits certain conduct related to Sutter Health’s contracting practices with insurance companies concerning network participation, steering, tiering, out-of-network pricing, new affiliate pricing, and availability of pricing information. The term of the Final Judgment is 10 years with the possibility of a 3-year extension. As part of the Final Judgment, the Court appointed Dionne Lomax (the “Compliance Monitor” or the “Monitor”) of Affiliated Monitors, Inc., to monitor Sutter Health’s compliance with the Final Judgment. For more information on the Final Judgment, please see the About section of the website.

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What is a class action?

You may submit a complaint to the Compliance Monitor if you have an allegation that Sutter Health is not in compliance with the Final Judgment AND you have standing to bring a complaint, meaning you are a “Plaintiff” or “Insurer” as those terms are defined below. You are a “Plaintiff” for purposes of submitting a complaint to the Compliance Monitor if you are one of the following: UFCW & Employers Benefit Trust; a Class Member (as defined here); or the State of California. You are an “Insurer” for purposes of submitting a complaint to the Compliance Monitor if you are one of the following California licensed health care service plans and insurers: Aetna Health of California, Inc.; Aetna Health Management; Aetna Life Insurance Company; Anthem Blue Cross, Inc./Blue Cross of California; California Physicians’ Service (d/b/a Blue Shield of California); UnitedHealthcare Insurance Company; UnitedHealthcare of California; Cigna HealthCare of California, Inc.; Cigna Health and Life Insurance Company; and Health Net of California, Inc. If you are not a “Plaintiff” or “Insurer” and you wish to contact Class Counsel, the AGO and/or Sutter regarding a complaint, please see the Contact section of the website.

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Am I entitled to money from the Sutter Health Class Action?

While members of the “Class” may be entitled to monetary compensation, the Compliance Monitor and this website DO NOT handle any of the monetary provisions of the Final Judgment. If you believe you are entitled to, or have questions about, monetary compensation from the Final Judgment, you can visit the link below.

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What is a complaint that can be submitted to the Compliance Monitor?

A complaint is an allegation that Sutter is not in compliance with the Final Judgment. The Final Judgment can be found at the link below. If you have a complaint regarding Sutter, but that complaint does not pertain to Sutter’s contracting practices and its compliance with the Final Judgment, you have other options, including:

 

  • Contacting Sutter Health here
  • Contacting the California Attorney General’s Office here
See Final Judgement
May I submit a complaint to the Compliance Monitor?

You may submit a complaint to the Compliance Monitor if you have an allegation that Sutter Health is not in compliance with the Final Judgment AND you have standing to bring a complaint, meaning you are a “Plaintiff” or “Insurer” as those terms are defined below. You are a “Plaintiff” for purposes of submitting a complaint to the Compliance Monitor if you are one of the following: UFCW & Employers Benefit Trust; a Class Member (as defined here); or the State of California. You are an “Insurer” for purposes of submitting a complaint to the Compliance Monitor if you are one of the following California licensed health care service plans and insurers: Aetna Health of California, Inc.; Aetna Health Management; Aetna Life Insurance Company; Anthem Blue Cross, Inc./Blue Cross of California; California Physicians’ Service (d/b/a Blue Shield of California); UnitedHealthcare Insurance Company; UnitedHealthcare of California; Cigna HealthCare of California, Inc.; Cigna Health and Life Insurance Company; and Health Net of California, Inc. If you are not a “Plaintiff” or “Insurer” and you wish to contact Class Counsel, the AGO and/or Sutter regarding a complaint, please see the Contact section of the website.

Contact The Monitor
Am I part of the Class?

Please review this criteria to see if you are part of the Class.

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How do I submit a complaint to the Compliance Monitor?

All complaints to the Compliance Monitor shall be submitted through this website. To submit a complaint, please follow the link below.

See Final Judgement
What will happen after I submit a complaint through this website?

Upon receipt of a complaint through this website, the Monitor will review your submission. You may be asked to provide supporting documentation, additional information, or be interviewed by the Monitor. For more information on the Compliance Monitor’s investigation process, please see the Monitoring Rules of Complaint Procedure linked below.

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Do I need to provide documentation or support for my complaint?

Yes. The Monitor’s Complaint Submission Portal will provide you with a standardized complaint intake form and allow for the upload of documentation in support of the complaint allegation(s). A complaint submitted to the Compliance Monitor shall be accompanied by any documents or other information supporting the complaint and the allegations of a violation of the Final Judgment.

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Will the Compliance Monitor appoint me a lawyer in connection with my complaint?

No. The Compliance Monitor will not appoint you a lawyer in connection with your complaint. The Court appointed lawyers to serve as Class Counsel and work on behalf of the Class. If you are a Class Member, Class Counsel may be contacted at ClassCounsel@PillsburyColeman.com. If you wish to retain a lawyer to represent you in connection with your complaint, you may do so at your own expense.

Email Class Councel
How long does it take the Compliance Monitor to respond to my complaint?

The Monitor will strive to have a determination completed as soon as practicable or within thirty (30) days of receiving a complete complaint and timely response(s). In expedited cases, the Monitor will strive to have a determination completed as soon as practicable or within fifteen (15) days of receiving a complete complaint and timely response(s). For more information on the Compliance Monitor’s investigation process, please see the Monitoring Rules of Complaint Procedure linked below.

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If I am in contract negotiations with Sutter and we cannot come to an agreement on particular terms and conditions of the proposed contract, can I contact the Monitor to obtain the Monitor’s input on the issue in dispute?

No. The Monitor will not provide advisory opinions and will not act as a shadow negotiator or mediator during contract negotiations. The Monitor will only adjudicate disputes that implicate compliance with the Final Judgment after an impasse has been reached.

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What if I have a complaint about the medical treatment, care, or a bill I received at a Sutter Health hospital or one of Sutter Health’s affiliates?

The Monitor and this website DO NOT address individuals’ complaints about the medical treatment, care or bills received at a Sutter Health hospital or affiliates. If you have a complaint about the medical treatment, care, or a bill you received at a Sutter Health hospital or one of Sutter Health’s affiliates, you have other options, including:

Contacting Sutter Health here

 

Contacting the California Attorney General’s Office through the link below

Contact AGO
If I file a complaint with the Monitor, will my complaint be shared with Sutter Health?

Yes – if you file a complaint that Sutter Health is not complying with the injunctive terms of the Final Judgment, your complaint and the information included in the complaint may be shared with Sutter Health, as well as the California Attorney General’s Office and Class Counsel, subject to certain confidentiality protections as described in the Monitoring Protective Order (“Protective Order”), linked below. In order to take advantage of the express confidentiality protections in the Protective Order, your representative or a representative of your organization must sign the “Acknowledge and Agreement to Be Bound,” (Exhibit A of the Protective Order).

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How do I get more information?

For more information about submitting complaints to the Compliance Monitor, you may send an email to: SutterMonitor@Affiliatedmonitors.com

For more information about the lawsuit, please visit www.SutterHealthLawsuit.com

You can get a copy of the complaint, the Settlement Agreement, and other important information about the lawsuit from the Court’s docket which can be accessed online at the link below.

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How do I file a complaint with the California Attorney General’s Office?

To submit a complaint to the California Attorney General’s Office, please follow this link to their website:

Contact AGO