Sutter Health was absolved this week from a California whistleblower lawsuit alleging the nonprofit system owed $519 million for double-billing patients.
After a seven-week trial, Alameda County Superior Court Judge Stephen Kaus ruled Monday retired surgeon Dr. Gregory Duncan and patient Gary Hulbert failed to show that Sutter’s billing practices for surgical patients were fraudulent.
Duncan and Hulbert accused Sutter of having overcharged patients since 2013 by allowing anesthesiologists to unnecessarily perform nerve-blocking procedures in the operating room and not properly documenting the need for performing them in that setting, resulting in double-billing. Kaus, however, ruled Sutter’s practices were appropriate and did not misrepresent the treatment to payers.
“Sutter’s bills accurately reflect the services provided to patients and are consistent with the national billing guidelines. At its core, [Monday’s] ruling preserves the integrity of our physicians’ clinical decision-making,” Sutter said in a statement.
Sacramento, California-based Sutter has roughly 50,000 employees serving more than 3 million patients across northern California.
Nonprofit Sutter has been investing heavily in outpatient care. It plans to add more than two dozen ambulatory care centers, in addition to primary and multispecialty sites, over the next few years. The health system acquired Santa Barbara, California-based Sansum Clinic in October and has pledged to invest in clinic renovations and new equipment.