Sutter Health LLC, a California-based health care services provider headquartered in Sacramento, and several of its affiliated entities were sued for allegedly violating the federal False Claims Act by submitting inaccurate billing codes related to the health status of patients. The false claims allegedly netted Sutter millions of dollars in overpayments.
The DOJ filed a separate federal complaint in March in support of a whistleblower lawsuit filed in 2015 against Sutter and Palo Alto Medical Foundation alleging the same practices.
Sutter contracted with Medicare Advantage organizations and received a share of the payments the organizations received from Medicare for health services provided to patients. Sutter allegedly submitted diagnoses codes for more serious diagnoses than patients had, which resulted in higher reimbursements from the federal government, according to the Department of Justice.
On Friday, federal officials maintained that Sutter knowingly submitted the claims with the incorrect codes.
Sutter didn't respond to the Weekly's questions on how or if the $30-million payout might affect patient services at Sutter facilities.
Palo Alto offers raises to largest labor union
Citing significant recruitment and retention challenges, Palo Alto is preparing to approve a new three-year contract with the city's largest labor union that would include an immediate 3.5% salary hike and raises as high as 20% for critical utilities positions that have been particularly difficult to fill.
The city's contract with the Service Employees International Union, Local 521, also will give the union's 580 employees a 3.5% raise on Dec. 1 and a 3% raise on Dec. 1, 2020, while requiring them to add an additional 1% of their salaries toward the "employer paid" portion of pension contributions. The city had traditionally footed the entire employer-paid portion, but has recently required workers to contribute 1%, which would be raised to 2% starting in Dec. 1, 2020.
Some of the biggest salary increases will be in the Utilities Department, where recruiting challenges have been most acute. The city's electric operation, which has 68 positions, has 18 vacancies, including all three electrical assistant positions, according to a Feb. 6 presentation that utility staff gave to the Utilities Advisory Commission. And five of the department's 15 electrical lineperson positions were vacant, requiring the city to increasingly rely on contractors to maintain transmission lines.
Tomm Marshall, assistant director of utilities, told the commission at the meeting that the city is also likely to see "a large number of people" leaving the city at the end of the year, in many cases because of retirement. Currently, some utilities employees commute from as far as Lodi and at least one lives in a car throughout the week, he said.
"After a while, they look for closer jobs so that they don't have to make the two-to-three-hour commute each way to get here," Marshall told the commission.
According to city data, in 2017 the lineperson position had a pay rate of between $46.90 and $61.51 per hour, with the highest paid lineperson earning $161,672 in total compensation that year (which included $37,160 in overtime).
The new contract tries to make these positions more lucrative by adding a 20% salary increase in addition to the across-the-board increases every union member will receive. When coupled with the two subsequent across-the-board salary increases granted to all SEIU employees, workers in these and other hard-to-fill positions would get a 30% raise over the contract's three-year term.
The proposed contract, which the City Council is scheduled to approve on April 22, is estimated to increase city costs by $3.7 million in fiscal year 2020 (which begins on July 1, 2019), and by $4.4 million and $4.8 million in the two subsequent years.
Despite the increased expenditures, top management believes the adjustments are necessary to bring stability to a workforce that beset with vacancies — a trend that staff attributes largely to the high cost of housing.
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