Sutter Health federal antitrust trial starts this week

Sutter Health federal antitrust trial starts this week

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A federal jury trial is slated to begin Thursday in an antitrust case against Sutter Health. Unlike the similar case in California that was settled hours before opening argumentsboth parties say they’re eager to get in front of a judge.

In the class-action lawsuit, called Sidibe v. Sutter Healthfully insured health plans accuse the Sacramento, California-based health system of imposing all-or-nothing contracts that have forced employers and millions of members to overpay by hundreds of millions of dollars over the years. It also accuses Sutter of putting tying arrangements in its insurance contracts, or forcing insurers to include certain services in contracts as a condition for accessing other services.

The claims are almost identical to those in the highly publicized UFCW & Employers Benefit Trust v. Sutter Health, which Sutter paid $575 million to settle in addition to abiding by strict rules governing its business practices. The difference is that UFCW centered on harm to self-insured plans, large businesses that fund their own workers’ claims, while Sidibe concerns fully insured plans, those run by health insurers.

Jury selection starts Wednesday in the Sidibe case, and opening statements are scheduled for Thursday.

“The plaintiffs are ready to go,” said Matthew Cantor, lead counsel for the Sidibe plaintiffs and a partner with Constantine Cannon. “We look forward to trying this case to verdict and we’re very confident.”

In its own statement, Sutter seemed similarly eager for trial to start. Spokesperson Amy Thoma Tan wrote in an email that the case concerns Sutter’s contracting practices with the five largest insurance companies in California.

“We look forward to telling our story in court and demonstrating that in Northern California’s highly competitive market, Sutter’s integrated healthcare network provides high-quality care that creates efficiencies, drives down total cost of care and benefits the diverse communities we serve,” she wrote .

Notice has already gone out to potential class members. They include anyone who paid premiums to Aetna, Anthem, Blue Cross, Blue Shield of California, Health Net or UnitedHealthcare since Jan. 1, 2011.

The class could include more than 3 million people, according to Cantor’s estimates. Although more than 6 million postcards and emails went out to potential class members, he said many of those were to people who were covered under multiple insurers during the relevant time period. Those who received the notification but are not part of the class were required to opt out, and about 260 people did so. Only one of those was a business, which Cantor said was surprising.

Legal experts have told Modern Healthcare that the Sidibe plaintiffs have a tougher road ahead than their UFCW counterparts because they not only have to prove that Sutter’s conduct resulted in higher costs, but that insurers passed on the higher costs to premium payers.

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