Sutter Health beats $519M double-billing allegations

Sacramento, Calif.-based Sutter Health beat a whistleblower’s lawsuit alleging that the health system owed $519 million for double-billing expensive operating room services without documentation, Law360 reported June 20. 

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A California state judge found that the whistleblower did not show that Sutter’s billing practices were fraudulent or that the payers expected to be charged differently, according to the report. 

The judge’s decision followed a seven-week bench trial that began in September, according to the report. The suit alleged that since 2013 Sutter Health had performed nerve-blocking procedures in operating rooms without documentation of the necessity for such procedures. One of the plaintiffs was a retired former orthopedic surgeon who worked within the Sutter Health system.

A Sutter spokesperson told Law360 that it is pleased with the court findings. The spokesperson said evidence at the trial showed Sutter’s bills “accurately reflect the services provided to patients and are consistent with the national billing guidelines.” 

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