California ex rel. Becerra v. Sutter Health, No. 18-565398
State sued Sutter Health, the largest hospital system in northern California, alleging that Sutter engaged in anticompetitive behavior in violation of the Cartwright Act by 1) establishing, increasing and maintaining Sutter’s power to control prices and exclude competition; 2) foreclosing price competition by Sutter’s competitors; and 3) enabling Sutter to impose prices for hospital healthcare services and ancillary products that far exceed the prices it would have been able to charge in an unconstrained, competitive market. The complaint alleges that Sutter did this by: Preventing insurance companies from negotiating with it on anything other than “all or nothingâ€ system-wide basis, requiring health insurers under the terms of contract with Sutter Health to negotiate with all the Sutter Health system or face termination of their contract; Preventing insurance companies from giving consumers more low-cost health plan options, for example, charging a $200 out-of-pocket cost for an outpatient surgery performed by a facility outside of the preferred group and $100 for outpatient surgery performed by a facility inside the preferred group; Setting excessively high out-of-network rates for patients who must seek care outside of their provider network; Restricting publication of provider cost information and rates. The complaint alleged three causes of action under the Cartwright Act: price tampering and fixing; unreasonable restraint of trade; and combination to monopolize. The state sought injunctive relief, disgorgement and attroneys fees.