• Sam Wares

UFCW & Employers Benefit Trust v. Sutter Health

Updated: Apr 8



Settlement Fund: $575,000,000


Class Period: January 1, 2003 to January 26, 2019


Claim Filing Deadline: May 28, 2021


Defendants: Sutter Health and several of its affiliates (“Sutter”)


Overview

Preliminary Approval of the settlement was granted on March 9, 2021 and the claim filing deadline has been set for May 28, 2021. This settlement is for the benefit of organizations in California with a self-funded benefit plan that meet the specific criteria noted below. MCAG will submit claims for our eligible clients and distribute notifications to clients if any information is required to finalize a claim submission.


The Plaintiff alleges that Sutter Health violated California’s antitrust law, the Cartwright Act, and California’s Unfair Competition Law. In particular, Plaintiff alleges that Sutter included provisions in its provider agreements with the major health insurance companies in California resulting in restricting price competition between Sutter and other general acute care hospitals in Northern California. The proposed settlement also claims that this reduction in price competition has permitted Sutter to overcharge self-funded payors and others for its general acute care hospital services and ancillary products. Plaintiff seeks to recover damages on behalf of the class and to prohibit Sutter from continuing to engage in the alleged anticompetitive practices.


Sutter denies that it did anything wrong and denies that Plaintiff and the Class are entitled to receive any money or other relief from Sutter. This lawsuit is ongoing, and the Court has not yet decided who will win or lose this case.


Eligibility

All self-funded payors that (1) are citizens of California for purposes of 28 U.S.C. § 1332(d) or arms of the State of California and (2) compensated Sutter for general acute care hospital services or ancillary products. The timeframe generally covers services from 2003 to January 2019.


If you qualify as a member of the class, the proposed settlement states that claims will include alleged overcharges paid to Sutter:

  • For services provided between January 1, 2003 and October 27, 2018 at prices set by contracts between Sutter and Aetna;

  • For services provided between January 1, 2003 and October 31, 2018 at prices set by contracts between Sutter and Anthem;

  • At any time from January 1, 2003 to December 31, 2018 at prices set by contracts between Sutter and Blue Shield;

  • For services between January 1, 2003 and August 25, 2018 at prices set by contracts between Sutter and Cigna; or

  • At any time from January 1, 2003 to January 26, 2019 at prices set by contracts between Sutter and United.

It is proposed that claims will not include any alleged overcharges: (1) paid to Sutter in connection with Blue Shield’s Flex Funded products; (2) paid through UMR, a subsidiary of UnitedHealthcare; or (3) in connection with services or payments (whichever is applicable) later than the dates listed in the preceding paragraph.


You are a citizen of California if: (a) you are organized under the laws of California, or (b) you have your principal place of business in California. For purposes of class membership, you are considered a citizen of California if you were a California citizen on April 7, 2014, regardless of whether you remained a California citizen after that date. If you are a California governmental entity (including, but not limited to, a city, a county, a hospital district, a school district, a fire protection district, a water or irrigation district, a transit or transportation district, a joint powers agency or authority, a public university, a department within the State, a superior court, the Judicial Council of California, or the Major Risk Medical Insurance Program) and are also a self-funded payor that compensated Sutter, you are included in the class, whether or not you are a California citizen.


Need more information? Call MCAG at 1-800-355-0466 to learn more or CLICK HERE to complete our contact form and an MCAG representative will respond shortly.
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