FROM THE FOUNDATION

All Over the Map

Newly updated to include breast cancer, prostate cancer, and spine procedures, this CHCF-sponsored research shows that practice patterns vary dramatically from place to place.

Medi-Cal Transforms

Medi-Cal is the main source of health insurance for one in five Californians. An updated report gives an overview of the program's key features, describes how the program is evolving, and examines the challenges ahead.

Obama Care in the Second Term

CHCF is a long-time sponsor of the UC Irvine Forecast Conference. A webcast of this year's conference on health policy in President Obama's second term is now available.

Hospitals

Monday, September 17, 2012

Federal Judge Dismisses Prime's Lawsuit Against Kaiser Permanente, SEIU

A federal judge recently dismissed a lawsuit filed by Prime Healthcare Services alleging that Kaiser Permanente and the Service Employees International Union violated the Sherman Antitrust Act by seeking to weaken Prime's business in California, California Watch reports (Jewett, California Watch, 9/17).

Background

Prime's lawsuit -- filed in November 2011 -- alleged that SEIU, in exchange for wage concessions, has aided Kaiser's efforts to diminish Prime's market viability.

According to Prime, SEIU promoted false media stories about problems at its hospitals, including reports of high rates of blood infections. The lawsuit alleged that SEIU also campaigned against the health system's efforts to acquire Victorville-based Victor Valley Community Hospital.

In addition, Prime's lawsuit claimed Kaiser withheld more than $100 million in reimbursements for care delivered to Kaiser members who received treatment at Prime facilities.

The lawsuit sought injunctive relief to prevent activities that Prime alleges SEIU and Kaiser participated in, including disrupting Prime's business and "coercing or threatening patients" not to seek care at Prime hospitals. The lawsuit also sought unspecified monetary damages (California Healthline, 11/16/11).

Details of Decision

On Aug. 30, Judge Janis Sammartino filed an order granting Kaiser's motion to dismiss the lawsuit.

The judge ruled that the facts stated in Prime's complaint did not support an antitrust lawsuit, noting that Prime "has not sufficiently pleaded specific facts suggesting a conspiracy."

Sammartino gave Prime 21 days to file a new complaint.

Response To Decision

Edward Barrera, spokesperson for Prime, said that the company plans to file a new complaint "to address the issues raised by the court" and that Prime "looks forward to moving this case forward."

In a statement last week, SEIU-United Healthcare Workers West said, "This dismissal confirms that Prime's lawsuit was simply an attempt to divert attention away from continuing allegations of potential Medicare fraud" (California Watch, 9/17).

Last year, the California Department of Public Health looked into claims that Prime "upcoded" bills for Medicare and Medi-Cal beneficiaries and referred the matter to CMS officials. Medi-Cal is California's Medicaid program.

Prime officials have said that allegations of upcoding patient bills are false (California Healthline, 6/6).



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