CATHOLIC HEALTHCARE WEST CLASS ACTION SETTLEMENT

The lawsuit claimed that Catholic Healthcare West (or CHW) charged uninsured patients too much for treatment or services, and rates that were not regular or reasonable. The lawsuit also claimed that Catholic Healthcare West charged uninsured patients rates that are far higher than the rates charged to patients with private insurance or on Medicare. Plaintiffs brought claims under California Business and Professions Code งง 17200, et. seq. (“The Unfair Competition Act”), California Civil Code งง 1750 et. seq. (“California Consumers Legal Remedies Act”), as well as claims for breach of contract, breach of the duty of good faith and fair dealing, and unjust enrichment.

The lawsuit also claimed that CHW used unfair and aggressive collection practices against uninsured patients.

To obtain more information about the Plaintiffs’ claims in this lawsuit, you can obtain the First Amended Complaint from www.CHWsettlement.com.

What is a class action and who is involved? (top)

In a class action lawsuit, one or more people called “Named Plaintiffs” or “Class Representatives” (in this case, Adrienne Dancer and Amber T. Howell) sue on behalf of other people who have similar claims. The people with similar claims together are a “Class” and the individuals are called “Class Members.”

Catholic Healthcare West (or CHW) is called the Defendant.

The court decides whether the proposed Settlement is fair, adequate and reasonable for everyone in the Class – except for those people who choose to exclude themselves from the Class.

Why is there a Settlement? (top)

The Court did not decide in favor of Plaintiffs or Defendants. The Plaintiffs thought they would have won monetary compensation and injunctive relief if there was a trial; and Defendants thought that Plaintiffs would have won nothing.

But there was no trial. Instead, both sides agreed to the Settlement. That way, they avoided the cost of a trial, and the Class Members may get compensation. The Class Representatives and the lawyers for the Class think the settlement is best for all uninsured patients.

II. Who Is In The Settlement

You may be affected by this lawsuit.

Am I part of this Settlement? (top)

The Honorable Judge Kramer preliminarily certified a Settlement Class that includes people who:

received Hospital Services from a CHW hospital between July 1, 2001 and September 25, 2006,
were uninsured at the time of receiving the Hospital Services, and
had $250,000 or less in gross annual household income in the calendar year in which treatment was received.

Are any uninsured patients who received Hospital Services between July 1, 2001 and September 25, 2006 at a CHW hospital not included in the Class? (top)

Yes. If you were uninsured (not covered by medical insurance or a government program, such as Medicare, Medicaid, Champus/TriCare Veterans Administration, etc. at the time of medical treatment) and received Hospital Services at a CHW hospital between July 1, 2001 and September 25, 2006, you may still be excluded from the Class if your gross annual household income was greater than $250,000 in the year you received treatment.

What “Hospital Services” are included? (top)

“Hospital Services” means the following goods and services provided in the CHW hospitals:

emergency medical services provided in an emergency room setting;
services for a condition which, if not reasonably timely treated, would lead to an adverse change in the health status of an individual;
non-elective services provided in response to life-threatening circumstances in a non-emergency room setting;
medically necessary services provided to Medicaid beneficiaries that are not covered by their respective Medicaid programs; and
any other medically necessary services not contemplated in (a) – (d) above, evaluated on a case by case basis at the CHW Facility’s discretion.

Those goods and services that are not Hospital Services include the following:

goods or services provided principally for cosmetic purposes;
elective goods or services not necessary to treat an illness or injury;
experimental goods or services (including, but not limited to, those provided to a patient as part of a clinical trial or research program);
physician services, treatments or procedures, and
goods or services covered by any Third-Party Payor.

I’m still not sure if I am included. (top)

If you are still not sure whether you are included, you can get help by calling 1-866-898-5158, or writing to the lawyers in this case, at the address provided here.

III. The Settlement Benefits – What You Get

What does the Settlement provide? (top)

Catholic Healthcare West:

will give compensation – representing a 35% discount from actual charges – to all uninsured patients who were charged for Hospital Services at a Catholic Healthcare West hospital between July 1, 2001 and September 25, 2006 and who had gross annual household income of $250,000 or less in the year receiving the Hospital Services, and who submit a Claim Form; the discount shall be provided by either a bill adjustment or, where appropriate, by monetary refund;
has modified its policies for the uninsured in the future so that all uninsured patients will be charged no more than the highest managed care rate (and, regardless, will never be charged more than 75% of charge master rates (“sticker price”);
will maintain a charity care policy so that patients with low to moderate income levels may be eligible to receive more substantial discounts or even free care;
will make sure uninsured patients are better advised about CHW’s uninsured patient and payment assistance discounts and financial counseling services; and
has changed its practices for collecting from low income uninsured patients, including capping the percentage of such patients’ annual income subject to collections.

What do I get from the Settlement? (top)

Retrospective Relief from Prior Hospital Bills: Discounts or Refunds

If you believe you are eligible for a refund or discount from your prior hospital bill(s), you may complete a simple Claim Form which may entitle you to receive a 35% discount from actual charges. If you were charged for Hospital Services and already paid your bills, you may receive a refund. If you were charged for Hospital Services, but have not paid those charges in full, you may receive either a refund or a discount on your outstanding charges on your prior bill(s).

Catholic Healthcare West has agreed that no information provided in the claims process will be used for collections purposes.

Prospective Relief: Improved Charity Care Policy to Protect the Uninsured

Under the proposed Settlement, Catholic Healthcare West will modify its policies for how it treats billing and collecting from all of its uninsured patients earning adjusted gross household income of $250,000 or less. These new policies will extend for four years under the Settlement.

Specifically, the prospective relief includes the following:

free financial counseling for uninsured patients;
creation of an Uninsured Patient Discount Policy under which all uninsured patients earning $250,000 or less will be charged no more than CHW’s highest managed care rate (and regardless, will not be charged more than 75% of the hospital’s charge master rate (“sticker price”));
CHW’s Patient Payment Assistance Policy will provide charity care discounts of up to 100% for low and moderate income uninsured patients;
ensuring that that hospitals better inform patients about financial counseling and CHW’s Uninsured Patient Discount Policy and Patient Payment Assistance Policy;
offering reasonable payment terms and flexible payment schedules;
limitations on the type of collections practices available for collecting from low income uninsured patients, including capping the percentage of such patients’ annual income subject to collections; and
continuation of prompt pay discounts.

Lawyers for the Class believe these changes will reduce charges to uninsured patients and improve the way uninsured patients are billed at CHW hospitals.

IV. Getting a Refund or Discount: Submitting a Claim Form

How can I get a discount or refund? (top)

To qualify for a refund or discount from your prior hospital bill(s), you must send in a Claim Form in which you need to verify that you were uninsured at the time of treatment and that your household income was $250,000 or less for the year of treatment. You may also get these forms by clicking here. Please read this Notice and the forms carefully, fill out the form you choose to submit, include all the information and documents the form asks for, sign it, and mail it postmarked no later than March 8, 2007.

Catholic Healthcare West has agreed that no information provided in the claims process will be used for collections purposes.

When will I get my discount or refund? (top)

The Court will hold a hearing on January 11, 2007, to decide whether to approve the settlement. If Judge Kramer approves the Settlement, there still may be appeals of his decision. It’s always uncertain whether these appeals can be resolved, and resolving them can take time, perhaps more than a year.

Everyone who sends in a claim form will be informed of the progress of the settlement. Please be patient if you do not receive a response immediately.

If I haven’t paid my bill in full and will get no refund, why should I submit a claim form? What is the benefit of getting a discount on my prior bill(s)? (top)

If you have not paid any or your entire bill, your outstanding bill will be recalculated so that your debt is reduced, and you may not receive a refund.

The lawyers for the Class encourage you to submit a Claim Form to reduce your debt even if you will not get a money refund. By sending a claim form, you may substantially reduce your debt.

Even if you do not eliminate your debt, a recalculated discounted hospital bill may allow you to maintain a positive credit rating or may help you repair your credit rating if it was lowered due to your outstanding medical care debt. Having a better credit reporting may help you with access to financial services where your credit score is monitored.

What am I giving up to get a payment or stay in the Class? (top)

Unless you exclude yourself, you are staying in the Class, and that means that you can’t sue, continue to sue, or be part of any other lawsuit against Catholic Healthcare West, its hospitals or related individuals about the legal issues in this case (including about prices for hospital treatment or services, or collection practices relating to the hospital bills), including through Estupinian v. Catholic Healthcare West, Los Angeles Superior Court Case No. BC 341 148, the case that is currently pending together with the Dancer case, ever again. It also means that all of the Court’s orders will apply to you and legally bind you.

In summary, “Released Claims” means and includes any and all claims, demands, rights, damages, obligations, suits, debts, liens, contracts, agreements and causes of action of every nature and description whatsoever, that were or could have been brought against Catholic Healthcare West and/or its hospitals and related individuals between July 1, 2001 and September 25, 2006, based upon or related to any charges incurred, or any billing, pricing or collection activity arising from facts that were alleged in the Complaint, at any hospital or medical facility of any kind owned or operated by Catholic Healthcare West. “Released Claims” does not include claims raised by way of an affirmative defense to a collections action, nor claims for personal injury or medical malpractice or other claims related to the quality or standard of care provided to patients.

The complete description of the “Released Claims”—that is, all claims you will be giving up if you stay in the Settlement Class—is in the Settlement Agreement, click here to review.

V. Excluding Yourself from the Settlement

If you don’t want a payment from this Settlement, but you want to keep the right to sue or continue to sue Catholic Healthcare West on your own about the legal issues in this case, then you must take steps to get out. This is called excluding yourself — or is sometimes referred to as opting out of the Settlement Class.

How do I get out of the Settlement? (top)

To ask to be excluded, you must send by mail a letter titled “Exclusion Request,” or complete this document “Exclusion Request Form,” asking to be excluded from the settlement class in Adrienne Dancer and Amber T. Howell v. Catholic Health Care West. Be sure to include your name and address and sign the letter, and include the following statement:

I understand that I am requesting to be excluded from the class monetary settlement and that I will receive no monetary refund or debt reduction under the settlement entered into by Catholic Healthcare West. I understand that if I am excluded from the class settlement, I may bring a separate legal action, but may receive nothing or less than what I would have received if I had filed a claim under the settlement procedure in this case.

You must mail your Exclusion Request postmarked by December 22, 2006 to: CHW Settlement, P.O. Box 1844, Faribault, MN 55021-1892.

If you ask to be excluded, you will not get any settlement payment, and you cannot object to the settlement. You will not be legally bound by anything that happens in this lawsuit. You will be able to sue (or continue to sue) Catholic Healthcare West as part of any other lawsuit about the same legal claims that are the subject of this lawsuit. If you ask to be excluded, there is another lawsuit pending that may allow you to continue to prosecute claims that this class action settlement will resolve if finally approved by the Court. That case, Estupinian v. Catholic Healthcare West, Case No. J.C.C.P. 4453, was filed as a class action and is also pending in the San Francisco Superior Court. Information about that case and the attorneys involved in it is available from any of the counsel in the Estupinian case: Archie C. Lamb and Chris W. Cantrell of The Lamb Firm LLC, 2017 Second Avenue North, Suite 200, Birmingham, Alabama 35203 (205-324-4644, or archielamb.com); Wayne S. Kreger and William A. Baird at Milstein, Adelman & Kreger LLP, 2800 Donald Douglas Loop North, Santa Monica, CA 90404 (310-396-9600 or www.maklawyers.com); E. Kirk Wood, Law Offices of E. Kirk Wood, P.O. Box 382434, Birmingham, AL 35238 (205-612-0243); or Don Howarth, Suzelle M. Smith and Paul Llewellyn at Howarth & Smith, 523 W. 6th St., Suite 728, Los Angeles, CA 90014 (213-955-9400, or www.howarth-smith.com).

You may hire and pay for an appropriate lawyer or contact one of the above counsel in the Estupinian case. If you decide to exclude yourself from the settlement, you should talk to an appropriate lawyer soon because your claims may be subject to a statute of limitations (meaning that the time limit for you to file a lawsuit may be running out).

If I don’t exclude myself, can I sue Catholic Healthcare West for the same thing later? (top)

No. Unless you exclude yourself, you give up any right sue, continue to sue, or be part of any other lawsuit against Catholic Healthcare West about the legal issues in this case. It also means that all of the Court’s orders will apply to you and legally bind you even if you do not submit a claim form.

If you have a pending lawsuit speak to your lawyer in that case immediately. You must exclude yourself from this Class to continue your own lawsuit. Remember, the exclusion deadline is December 22, 2006.

If I exclude myself, can I get money from this Settlement? (top)

No. If you exclude yourself, please do not send in a claim form to ask for any refunds or discounts. However, you may sue, continue to sue, or be part of a different lawsuit against CHW or its hospitals.

If I exclude myself, and I change my mind, can I get back into the Settlement? (top)

If you exclude yourself from the Class and Settlement, and later decide that you want to participate in the Settlement, you can withdraw or rescind your exclusion request by submitting a “Rescission of Exclusion Request,” or the attached “Rescission of Exclusion Request Form” to the Claims Administrator. If you change your mind you should send the Claims Administrator a statement that includes your name, address, and telephone number and the following language:

I previously submitted an Exclusion Request seeking exclusion from the class monetary settlement. I have reconsidered and wish to withdraw my Exclusion Request. I understand that by rescinding my Exclusion Request I may be eligible to receive a monetary refund or debt reduction under this Agreement and release claims under the terms of this Agreement.

You should sign and date the statement and send it to the Claims Administrator no later than December 22, 2007.

VI. The Lawyers Representing You

Do I have a lawyer in this case? (top)

The Court decided that the law firms of Lieff, Cabraser, Heimann & Bernstein, LLP; the Scruggs Law Firm; and Bartimus, Frickleton, Robertson & Gorny are qualified to represent you and all Class Members. Together the law firms are called “Class Counsel”. They are experienced in handling class actions and similar cases against other non-profit hospitals. More information about these law firms, their practices, and their lawyers’ experience is available at: www.lieffcabraser.com and www.bflawfirm.com.

Should I get my own lawyer? (top)

You do not need to hire your own lawyer because Class Counsel is working on your behalf. If you want your own lawyer, you may hire one, but you will have to pay that lawyer. For example, you can ask him or her to appear in Court for you if you want someone other than Class Counsel to speak for you. You may also appear for yourself without a lawyer.

How will the lawyers be paid? (top)

Class counsel will ask the Court to approve payment of up to $1,275,000 to them for attorneys’ fees and expenses and payment of $1,000 to each of the Class Representatives (Adrienne Dancer and Amber T. Howell) for their services. The fees would pay Class Counsel for investigating the facts, litigating the case, and negotiating the settlement. The Court may award less than these amounts. Catholic Healthcare West will separately pay the fees, expenses and payments that the Court awards. These amounts will not reduce the money available for Class Members for retroactive discounts or refunds. Catholic Healthcare West has agreed not to oppose these fees and expenses. Catholic Healthcare West will also pay the costs to administer the Settlement.

VII. Objecting To The Settlement

You can tell the Court that you don’t agree with the settlement or some part of it.

How do I tell the Court that I don’t like the settlement? (top)

If you’re a Class Member, you can object to the Settlement if you don’t like any part of it. You can give reasons why you think the Court should not approve it. The Court will consider your views.

To object, you must send a letter saying that you object to the proposed Settlement in Adrienne Dancer & Amber T. Howell v. Catholic Healthcare West . Be sure to include your name, address, telephone number, your signature, and the reasons you object to the settlement. Mail the objection to the following address, postmarked no later than December 22, 2006:

Claims Administrator: CHW Settlement, P.O. Box 1844, Faribault, MN 55021-1892

What’s the difference between objecting and excluding? (top)

Objecting is simply telling the Court that you don’t like something about the Settlement. You can object only if you stay in the Class. Excluding yourself is telling the Court that you don’t want to be part of the Class. If you exclude yourself, you have no basis to object because the case no longer affects you.

VIII. The Court’s Fairness Hearing

The Court will hold a hearing to decide whether to approve the Settlement. You may attend and you may ask to speak, but you don’t have to do either.

When and where will the Court decide whether to approve the settlement? (top)

The Court will hold a Fairness Hearing at 9:30 a.m. on January 11, 2007 in Department 304 of the San Francisco Superior Court, located at 400 McAllister Street, San Francisco, California 94102.

At this hearing the Court will consider whether the settlement is fair, reasonable, and adequate. If there are objections, the Court will consider them. Judge Kramer will listen to people who have asked to speak at the hearing.

The Court also may decide how much to pay to Class Counsel. After the hearing, the Court will decide whether to approve the Settlement. We do not know how long these decisions will take.

Do I have to come to the hearing? (top)

No. Class Counsel will answer any questions Judge Kramer may have. Of course, you are welcome to come at your own expense. If you send an objection, you don’t have to come to Court to talk about it. As long as you mailed your written objection on time, the Court will consider it. You may also pay your own lawyer to attend, but it is not necessary.

May I speak at the hearing? (top)

You may ask the Court for permission to speak at the Fairness Hearing. To do so, you must send a letter saying that it is your “Notice of Intention to Appear in Dancer et al. v. Catholic Healthcare West.” Be sure to include your name, address, telephone number, and your signature.

Your Notice of Intention to appear must be postmarked no later than December 22, 2006, and be sent to the Claims Administrator at the CHW Settlement, P.O. Box 1844, Faribault, MN 55021-1892,. You cannot speak at the hearing if you excluded yourself.

IX. If You Do Nothing

What happens if I do nothing at all? (top)

If you do nothing, you’ll get no money from this Settlement. But, unless you exclude yourself, you won’t be able to start a lawsuit, continue with a lawsuit, or be part of any other lawsuit against Catholic Healthcare West about the legal issues in this case, ever again.

X. Getting More Information

Are more details about the Settlement available? (top)

Yes. The Notice and this website summarizes the proposed Settlement; more details are in the proposed Settlement Agreement. You can print a copy of the Settlement Agreement by clicking here or by writing to: CHW Settlement, P.O. Box 1844, Faribault, MN 55021-1892.

How do I get more information? (top)

You can write to CHW Settlement, P.O. Box 1844, Faribault, MN 55021-1892, or call 1-866-898-5158, where you will find answers to common questions about the Settlement, claim forms, plus other information to help you determine whether you are a Class Member and whether you are eligible for a payment.

You may also write to one of the lawyers at the addresses below:

Plaintiffs’ Counsel
Kelly M. Dermody
Caryn Becker
LIEFF, CABRASER, HEIMANN & BERNSTEIN, LLP
Embarcadero Ctr West
275 Battery Street, 30th Fl
San Francisco, CA 94111-3339

Richard F. Scruggs
Sidney A. Backstrom
Zach Scruggs, MSB
SCRUGGS LAW FIRM
120-A Courthouse Sq.
P.O. Box 1136
Oxford, MS 38655

Edward D. Robertson, Jr.
BARTIMUS, FRICKLETON, ROBERTSON & GORNY
715 Swifts Highway
Jefferson City, MO 65109

Defense Counsel
Peter Wald
Darius Ogloza
LATHAM & WATKINS LLP
505 Montgomery Street, Ste 2000
San Francisco, CA 94111

PLEASE DO NOT CONTACT THE COURT FOR INFORMATION. ALL QUESTIONS ABOUT THIS NOTICE OR THE CLASS ACTION SHOULD BE DIRECTED TO SETTLEMENT CLASS COUNSEL.