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Once-prominent Bakersfield attorney pleads guilty to insurance fraud – The Bakersfield Californian

attorneylegalcounsel99 — Mon, 08 Jan 2024 15:18:50 +0000

Once-prominent Bakersfield attorney pleads guilty to insurance fraud The Bakersfield Californian

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In the Spotlight | Cambria County attorneys establish law firm together in Ebensburg | News

attorneylegalcounsel99 — Sat, 06 Jan 2024 11:50:19 +0000

EBENSBURG, Pa. – As public defenders, John Lovette III and Joe Sutton have often worked side by side, representing people facing homicide charges who couldn’t afford a private attorney.

Now, the Cambria County attorneys are partnering again – opening a law firm together in Ebensburg.

Lovette, 43, of Westmont, and Sutton, 36, of Loretto, are both Penn State graduates with a combined 27 years’ experience practicing law, much of that time spent as Cambria County public defenders.

“We both work really well together and respect how the other handles business,” Lovette said.

And between the two of them, they’ve worked in just about every sector of law, representing clients from across the region, Sutton added.

That includes estate planning and administration, personal injury, civil litigation, wills and contract cases spanning from Allegheny to Blair counties, they said.

Among their recent criminal cases, Lovette and Sutton represented a Johnstown man, Chad Busch, who was facing the possibility of life in prison for his wife’s 2021 murder. Through a plea deal, Busch received a 20-year sentence in 2022.

“It’s a homicide case one day and a multi-million-dollar estate or six-figure dog bite case the next,” Sutton said. “That’s a week in the life for us.”

They described the move to open up a private practice as the “realization of a dream.”

Sutton was raised in the Loretto area. Lovette was born and raised in Westmont. Both returned to their hometowns after finishing law school – and are now raising families there, they said.

Lovette and his wife, Casey, are expecting their second child in May.

Lovette first worked as an associate attorney under his uncle, Dan Lovette, before joining the Cambria County Public Defender’s Office 15 years ago.

Sutton and his wife, Olivia, have two sons and a daughter.

Sutton became a public defender seven years ago. He worked nearly a decade for attorney and now-District Judge Dave Beyer.

Both Sutton and Lovette plan to continue serving as part-time public defenders, even as they continue adding more private work.

Ebensburg attorney and longtime Cambria County First Assistant District attorney Heath Long wasn’t surprised that Lovette and Sutton are establishing a law office.

He said Lovette and Sutton have proven themselves in the courtroom.

“They definitely represent the next generation of lead attorneys in Cambria County,” said Long, who has prosecuted cases against their clients.

He said both are great examples of how young attorneys can begin practicing as either a prosecutor or a public defender in Cambria County and, in just five or 10 years, “become excellent in their craft” by embracing the chance to be in front of a judge in court every day.

“They have roots here. It’s great to see them taking this step … and sticking around,” Long said.

The legal profession – like many across the region – is graying in Cambria County, with an increased number of attorneys retiring and reducing their caseloads.

Lovette and Sutton said they recognize that opens up opportunities for attorneys their age to fill that void.

The pair said their goal is to represent local residents, families and organizations for decades to come.

Someone who may need help fighting a speeding ticket as a young man or woman might one day need an attorney to close a property transaction or plan their estate in the decades ahead.

“We hope to serve a lot of needs – not just criminal defense,” Sutton said. “We’re planning to be here 30 or 40 years from now, serving the community.”

Their law office opened on Monday in Suite 307 of the First United Federal Building, 104 S. Center St. in Ebensburg Borough.

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Family of woman killed in Sept. 3 accident files lawsuit against driver … – Parker Pioneer

attorneylegalcounsel99 — Thu, 30 Nov 2023 02:10:23 +0000

Family of woman killed in Sept. 3 accident files lawsuit against driver … Parker Pioneer

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Papillion attorney processes war experience by writing novel

attorneylegalcounsel99 — Sun, 26 Nov 2023 19:34:24 +0000

A question at a party in 2019 led Papillion attorney John Waters to write his first book.

John Waters wrote a novel based on his experiences as a Marine in a war zone. He’s now 27 years old with a wife and three kids, and he works as an attorney for Fiserv.

The gathering was a fundraiser for Opera Omaha at the home of a colleague. Waters, who wasn’t an opera fan, felt alone and out of his element. When he listened to a talk about the company’s next performance, that feeling got stronger.

Then a singer performed “Danny Boy,” a sad Irish ballad about a mom who watches her son march off to war. That struck a chord with Waters, who graduated from the Naval Academy in Annapolis, Maryland, and spent time in Afghanistan and Iraq as a Marine.

He stopped to talk to the singer on his way out of the party.

“I told her I had gone to war,” he said, and she responded with a question: “Do you think a soldier ever comes home from war?”

It was an issue he’d never resolved, but one he wanted to contemplate. He had some questions of his own. And as he searched for answers, he was also developing a newfound interest in the arts.

“River Zone One,” by John Waters, is about a man’s return from war and his efforts to build a new life with a beautiful singer.

This month, his novel, “River City One,” was released by Permuted Press and distributed by Simon & Schuster. He had a launch party in Washington, D.C., hosted by his sister, Erin, the president and CEO of the Real Clear Politics website. He’s also had readings at Omaha’s Bookworm and in Iowa City.

“River City One” tells the story of John Walker, a lawyer and ex-Marine who has been on the edge since he came home from the war. He rages against people who don’t understand the terror he felt in combat and the guilt he still feels. Things turn around when he meets a beautiful singer, but his web of lies may destroy his renewed life.

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Papillion resident John Waters, who wrote a novel using his experiences as a Marine as fodder, is congratulated by President Barack Obama at his graduation from the Naval Academy in Annapolis, Maryland.

Waters, 37, has seen war, but he said the book is not autobiographical. After graduating from Annapolis, he became a lieutenant in the Marines and eventually was a ground intelligence officer in Afghanistan. He wasn’t in combat, but he did receive photographic proof that soldiers had captured and killed people he had located.

“Hemingway said to write what you know. I started with a place and people I know and feelings and memories I have,” Waters said. “What happens is not a memoir, (but) it is truthful to the experience of coming home. It is not about me. I wouldn’t force something on the world that was just about me.”

Once he decided to write the book, it took him only three months to complete the first draft, writing in pencil in a journal. He said he wanted it to be hard.

He worked surreptitiously in his basement. Only his wife and his mom knew about it. He said his dad, also named John, wasn’t pleased when he learned what was going on. Put it away, he told his son, and focus on your day job and your family.

The younger Waters soldiered on, writing the next draft in pen and typing the last one.

He prepared for the process by studying how various artists created. He also found a writing mentor and lived with him for six months.

And, he said, “I read everything I could. I was always a reader.”

His mom, Patricia Waters, edited the book before he sent it off to various agents and publishing companies. (She’s a former features editor at The World-Herald.) He said he contacted about 500 editors, writers and publishers before finding an agent in London.

He learned that to get ahead, writers also have to be marketers as well.

Papillion resident John Waters as a student at the Naval Academy in Annapolis, Maryland.

“The book was like my client,” he said. “It was hard, but I was a Marine and as a Marine I did hard things.”

He wrote his book, he said, because there was a lot he loved about his time in the corps. But like many soldiers, he felt somewhat lost when his military career ended in 2015.

“When I came home, I felt abandoned and alone. Writing was a comfort … I could be with old friends,” he said. “We come home and we’re feted as heroes but all we’re thinking about is what we didn’t do, where we fell short. I wanted to tell that story.”

The book has already received a couple of positive reviews, including this from Eugene Sledge Award-winning author Kacy Tellessen:

“John Waters renders real a fictional account of what it’s like to attempt to live an ordinary life after experiencing the extraordinary thumbprint of war. With rich prose and a touch of the surreal, Waters tells a story that will make you reflect on your own life, as all great stories do. ‘River City One’ is an utterly human story that demands to be read.”

Waters, who has three young children, said his wife has been very supportive throughout his journey. His seven-year-old son, Henry, has started writing books himself.

He frequently reads to Henry before bedtime.

“We came to the end of reading (one night) and we talked about his book, ‘Ben the Ant,’” Waters said. “And he says, ‘Someday I want to be like you.’”

Since he finished “River City One,” he said, he’s moved on from regular reflection about his military experiences and has found new interests. Writing it has helped him move on.

“It’s not so much in my head anymore,” he said.

He’ll continue to practice law; he now works as a corporate lawyer at Fiserv. But he also plans to continue writing. He has a contract for a nonfiction book, composes poetry and someday would like to produce a novel about love and romance.

“Writing, to me, is an impulse that I can’t do anything but indulge,” he said. “I have to do it.”

Our best Omaha staff photos & videos of November 2023

Brothers Finn, 10, and Jaxson Mlynarik, 14, of Winterset, Iowa, stand together with a lit up snowflake during the Holiday Lights Festival lighting ceremony at The RiverFront Park in Omaha on Saturday, Nov. 25, 2023.

ANNA REED, THE WORLD-HERALD

Sandhills/Thedford’s Zeb Wilde (32) and Carson Cooksley (14) celebrate with fans Kaden Haake and Connor Cooksley following the Wynot vs. Sandhills/Thedford Nebraska Class D2 State Football Championship at Memorial Stadium in Lincoln on Monday, Nov. 20, 2023. Sandhills/Thedford won the title 50-12.

ANNA REED, THE WORLD-HERALD

Creighton’s Trey Alexander (23) controls the ball in the Texas Southern vs. Creighton men’s college basketball game at the CHI Health Center in Omaha on Saturday, Nov. 18, 2023.

ANNA REED, THE WORLD-HERALD

Justin Holzepfel puts Christmas lights on his roof as his daughter, Madalyn, 5, watches on Tuesday, Nov. 14, 2023.

CHRIS MACHIAN, THE WORLD-HERALD

Nebraska’s Nick Henrich (3) pressures Wisconsin’s Tanner Mordecai (8) during the second half of a college football game at Camp Randall Stadium in Madison, Wis., on Saturday, Nov. 18, 2023.

CHRIS MACHIAN THE WORLD-HERALD

Nebraska’s Thomas Fidone II (24) huddles Wisconsin’s Jason Maitre (23) during the second half of a college football game at Camp Randall Stadium in Madison, Wis., on Saturday, Nov. 18, 2023.

CHRIS MACHIAN THE WORLD-HERALD

Nebraska’s Chubba Purdy (12) throws under pressure from Wisconsin’s Jake Chaney (36) during the first half of a college football game at Camp Randall Stadium in Madison, Wis., on Saturday, Nov. 18, 2023.

CHRIS MACHIAN THE WORLD-HERALD

Nebraska’s Chubba Purdy (12) scores on a 55-yard run on the first drive during the first half of a college football game at Camp Randall Stadium in Madison, Wis., on Saturday, Nov. 18, 2023.

CHRIS MACHIAN THE WORLD-HERALD

Nebraska’s Harper Murray (27) goes up for the ball during the first set of a college volleyball match against Michigan at the Devaney Center in Lincoln on Friday, Nov. 17, 2023.

ANNA REED, THE WORLD-HERALD

Jaye’real Coppage 12, dibbles a basketball in the gym at the Salvation Army Omaha North Worship & Service Center located at 2424 Pratt St, on Thursday, Nov. 9, 2023. Paint from the mural on the wall is peeling.

CHRIS MACHIAN THE WORLD-HERALD

Atlas Swan, 3, helps his mother, Eryn Swan’s plants on the porch of their Bemis Park home on Wednesday, Nov. 8, 2023.

CHRIS MACHIAN THE WORLD-HERALD

Kids play basketball in the gym at the Salvation Army’s North Corps Community Center, 2424 Pratt St., on Nov. 9.

CHRIS MACHIAN, THE WORLD-HERALD

North Dakota State’s Ryan Sletten (24) tries to stop a Creighton’s Ryan Kalkbrenner (11) dunk at CHI Health Center on Saturday, Nov. 11, 2023.

CHRIS MACHIAN THE WORLD-HERALD

Police escort a truck carrying the Durham Museum Christmas heads north on I480 toward Woolworth Avenue on Monday, Nov. 13, 2023.

CHRIS MACHIAN THE WORLD-HERALD

A Union Pacific climbs out of a tree after securing it to a crane on Monday, Nov. 13, 2023.

CHRIS MACHIAN, THE WORLD-HERALD

Creighton’s Steven Ashworth (1) celebrates a three-point basket against North Dakota State at CHI Health Center on Saturday, Nov. 11, 2023.

CHRIS MACHIAN THE WORLD-HERALD

North Dakota State’s Ryan Sletten (24) tries to stop a Creighton’s Ryan Kalkbrenner (11) dunk at CHI Health Center on Saturday, Nov. 11, 2023.

CHRIS MACHIAN THE WORLD-HERALD

Nebraska’s Ty Robinson (9) walks off the filed following the college football game at Memorial Stadium in Lincoln on Saturday, Nov. 11, 2023. Maryland won the game 13-10.

ANNA REED THE WORLD-HERALD

Nebraska’s Blaise Gunnerson (97) stretches out to try an block a pass from Maryland’s Taulia Tagovailoa (3) to Maryland’s Roman Hemby (24) during the first half of a college football game at Memorial Stadium in Lincoln on Saturday, Nov. 11, 2023.

ANNA REED THE WORLD-HERALD

Nebraska’s Harper Murray (27) watches as Nebraska’s Merritt Beason (13) misses the ball in the Northwestern vs. Nebraska college volleyball match at the Devaney Center in Lincoln on Wednesday, Nov. 8, 2023.

ANNA REED THE WORLD-HERALD

Brooke Holloway, Matthew McMullen Bill Holloway and Cindy Holloway cross the Red Cedar river on their way to Spartan Stadium prior to a college football game between the Nebraska Huskers and the Michigan State Spartans in East Lansing, Mich. on Saturday, Nov. 4, 2023.

CHRIS MACHIAN THE WORLD-HERALD

Nebraska and Michigan State fans react differently on a penalty call against Michigan State during the first half of a college football game at Spartan in East Lansing, Mich. on Saturday, Nov. 4, 2023.

CHRIS MACHIAN THE WORLD-HERALD

Nebraska’s Omar Brown (12) sits in a hall before playing Michigan State in a college football game at Spartan in East Lansing, Mich. on Saturday, Nov. 4, 2023.

CHRIS MACHIAN THE WORLD-HERALD

Nebraska’s Heinrich Haarberg (10), Nebraska’s Jeff Sims (7) and Nebraska’s Chubba Purdy (12) have a moment in a hall before playing Michigan State in a college football game at Spartan in East Lansing, Mich. on Saturday, Nov. 4, 2023.

CHRIS MACHIAN THE WORLD-HERALD

A member of the Michigan State marching band drums upside down during the second half of a college football game at Spartan in East Lansing, Mich. on Saturday, Nov. 4, 2023.

CHRIS MACHIAN THE WORLD-HERALD

Omaha Skutt raises their trophy following the Norris vs. Omaha Skutt Nebraska State Volleyball Class B Championship match at the Devaney Center in Lincoln on Saturday, Nov. 4, 2023. Omaha Skutt won the title in three sets.

ANNA REED, THE WORLD-HERALD

Sumner-Eddyville-Miller’s Katelynn Reiter (6) serves the ball in the O’Neill St. Mary’s vs. Sumner-Eddyville-Miller NSAA Class D-1 volleyball state quarterfinal match at the Pinnacle Bank Arena in Lincoln on Thursday, Nov. 2, 2023.

ANNA REED, THE WORLD-HERALD

Shania Twain performs at the CHI Health Center in Omaha on Thursday, Nov. 2, 2023.

NIKOS FRAZIER THE WORLD-HERALD

Millard West’s Brody Peterson (7) runs the ball against Grand Island’s Trey Engberg (1) and Grand Island’s Justyce Hostetler (35) during the first quarter of a high school football game at Buell Stadium in Omaha on Friday, Nov. 3, 2023.

NIKOS FRAZIER THE WORLD-HERALD

Minden’s Aubree Bules (11) serves the ball during the fourth set of the Nebraska state volleyball C-1 Championship against Kearney Catholic at the Devaney Center in Lincoln on Saturday, Nov. 4, 2023.

NIKOS FRAZIER THE WORLD-HERALD

Overton’s JoLee Ryan (7) and Overton’s Ashlyn Florell (10) celebrate after sweeping Cambridge to win the Nebraska state volleyball D-2 Championship at Devaney Center in Lincoln on Saturday, Nov. 4, 2023.

NIKOS FRAZIER, THE WORLD-HERALD

The sun sets behind Pinnacle Bank Arena before the Huskers’ men’s basketball team tips-off against Lindenwood in Lincoln on Monday, Nov. 6, 2023.

NIKOS FRAZIER THE WORLD-HERALD

Nebraska’s C.J. Wilcher (0) passes the ball against Florida A&M’s Jordan Chatman (2) during the first half of a college men’s basketball game at Pinnacle Bank Arena in Lincoln on Thursday, Nov. 9, 2023.

NIKOS FRAZIER, THE WORLD-HERALD

A look inside Memorial Stadium during the national anthem before the first quarter of a college football game in Lincoln on Saturday, Nov. 11, 2023.

NIKOS FRAZIER THE WORLD-HERALD

Nebraska’s Janiran Bonner (16) runs the ball past Maryland’s Beau Brade (2) to score a touchdown during the third quarter of a college football game at Memorial Stadium in Lincoln on Saturday, Nov. 11, 2023.

NIKOS FRAZIER, THE WORLD-HERALD

Nebraska’s Malcolm Hartzog (13) pushes Maryland’s Antwain Littleton II (7) out of bounds during the third quarter of a college football game at Memorial Stadium in Lincoln on Saturday, Nov. 11, 2023.

NIKOS FRAZIER, THE WORLD-HERALD

Creighton’s Trey Alexander (23) goes up to dunk the ball against Iowa’s Tony Perkins (11) during the second half of a men’s college basketball game at the CHI Health Center in Omaha on Tuesday, Nov. 14, 2023.

NIKOS FRAZIER THE WORLD-HERALD

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Kern district attorney targets landlords of illegal pot shops | News

attorneylegalcounsel99 — Sun, 19 Nov 2023 12:10:27 +0000

For all the progress she’s seen in a year-old campaign to counter a local surge in illegal pot shops — 24 shut down in recent months with perhaps twice that many still operating, mostly in Oildale and Rosamond — Kern County District attorney Cynthia Zimmer said it remains an uphill fight.

Sheriff’s deputies go in with search warrants one day, arresting employees and seizing cannabis, psychoactive mushrooms, cash and firearms, she said. Then the shop reopens, sometimes the same day, typically in the same storefront.

Zimmer’s trying something different lately. Her office now goes after landlords who rent to illegal cannabis dispensaries, in civil court instead of criminal, pursuing penalties of $2,500 per day the shop operates.

The strategy is new to Kern but not unique in California, where it’s seen as a way to enlist landlords who may not be aware of their tenants’ illegal operation. Prosecutors save time and money, even as landlords sometimes have trouble evicting criminal tenants and, in some cases, the shop ends up relocating a few blocks away.

So far, Zimmer’s civil division, normally focused on consumer fraud and the like, has filed seven lawsuits against commercial property owners. She said one case led to a $2 million judgment against the landlord.

“We’re very excited about this and we’re moving forward,” she said.

The lawsuits open a new front in the county’s battle against illegal marijuana sellers in unincorporated Kern. Although 24 pot shop workers have been arrested since the start of September, Zimmer said, local law enforcement has had less success bringing charges against actual operators.

Los Angeles cannabis law lawyer Seena Samimi agreed government in general is “always one step behind the operator,” who he said may just set up shop five blocks away. But that’s also why it makes sense to work with landlords, he added.

Property owners renting to an operation without a license to sell marijuana, Samimi said, are “just as guilty as the tenant is” because they are allowing a use that’s not permitted.

Some landlords in Southern California protest that the government’s actions are unconstitutional, in effect buying time to keep collecting highly profitable rents, he said. But others comply, allowing law enforcement to save substantial work.

A Beverly Hills lawyer recognized for his expertise in cannabis matters, William S. “Bill” Kroger, said he has a client with a series of shopping malls who was levied a $36 million fine by the city of Los Angeles for renting space to a series of dispensaries.

Landlords receiving twice normal rent, in some cases, often don’t understand they’re breaking the law, Kroger said. He added that enforcement against property owners in Southern California has been “kind of hit and miss.”

But even after landlords get “woken up” by prosecutors, he said, successfully kicking out tenants is another matter. Some fight back, he said, and some just don’t follow the law.

“It’s a battle to get them out,” Kroger said.

David Michaels knows the feeling.

After inheriting a shopping center in east Bakersfield, he fell ill from diabetes last summer and ended up under medical supervision for more than three weeks. When he got out of a rehabilitation hospital in early September, Michaels said, he found out someone had entered a long-vacant barbershop on his property, changed the locks and opened an unlicensed pot shop.

The operator has no lease and has paid no rent, he said. But when he called the Kern County Sheriff’s Office to remove the store, Michaels said, the responding deputy didn’t believe he owned the property. No action was taken, he added, even after his lawyer offered the deputy a copy of the deed.

Michaels called Zimmer’s office, he said, but was referred to the Better Business Bureau.

“Nobody will help me,” he said. “I’m very frustrated about this.” Michaels noted he has listed the shop for sale and plans to use the proceeds to buy a home in Los Angeles.

A KCSO spokeswoman said the agency has authority to help landlords remove illegal pot shops, but that how the process works depends on particular circumstances. She declined to comment on Michaels’ case without knowing details such as when exactly calls for service came in.

“It’s a case-by-case basis,” Public Information Officer Lori Meza said by email, “and if KCSO were to help a landlord facilitate the removal of a tenant, that would become a civil issue that gets referred to the civil unit, and that process could take months.”

Zimmer was unfamiliar with Michaels’ case but said a situation like he described would probably lead her office to give him additional time to remove a tenant before filing suit.

“We do understand that sometimes it is hard for the landlord to evict the client,” she said.

The county is concerned about illegal dispensaries because, Zimmer said, they often attract criminal behavior to surrounding neighborhoods and they sell marijuana that may contain illegal, carcinogenic pesticides.

Working with the KCSO and state authorities, the District attorney’s Office files for search warrants that, besides turning up hundreds of pounds of cannabis since August, also yield information her staff uses to send landlords a letter warning they may face penalties if they do not cease and desist.

Some cooperate, others get additional search warrants, Zimmer said. Whether they get hit with a lawsuit depends on how cooperative they are, she added.

Her office’s specific approach, developed in cooperation with Riverside and San Diego counties, accuses property owners of unfair competition violations, basically asserting they’re stealing business from licensed dispensaries elsewhere. The lawsuits her office files also accuse property owners of allowing a public nuisance and of breaking state cannabis regulation and drug abatement laws.

It’s only been a few months, but she said combining search warrants with arrests of pot shop employees with civil suits “seems to be an effective combination.”

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Who polices hospitals merging across markets? States give different answers | Local News

attorneylegalcounsel99 — Sun, 29 Oct 2023 10:39:04 +0000

St. Louis’ largest health system, BJC HealthCare, plans to merge with Kansas City’s second-largest, Saint Luke’s Health System, uniting more than 28 hospitals on both sides of Missouri by the end of this year.

The merger, which would span markets 250 miles apart and include facilities in neighboring Kansas and Illinois, is just one of the latest in a quickly consolidating hospital industry. Cross-market deals accounted for more than half of all hospital mergers and acquisitions during the last decade, according to a paper from experts on antitrust law. Today, nearly 60% of health systems operate multiple hospitals in different geographic markets.

Not only are such deals more common, they can increase costs for patients. Merged hospitals in the same state but in different markets raised prices as much as 10% compared with other hospitals, researchers found after analyzing past deals. A separate study found stand-alone hospitals raised prices 17% after they were acquired by a hospital company in another market.

But for some 50 years, federal regulators have not stepped in to prevent hospitals from merging with systems in other markets, according to antitrust law experts. Without federal intervention, states that have seen such megamergers, such as Michigan and California, are often left to wrestle with the complex question of how to respond, given the likelihood of higher prices for their residents.

The Federal Trade Commission and the Justice Department are reviewing public comments on draft merger guidelines designed to crack down on mergers in multiple sectors, including health care. It’s not yet clear if or how cross-market hospital mergers within a state could be affected. Still, the draft says consolidation should not “entrench or extend a dominant position” by extending into “new markets.”

But such cross-market mergers aren’t quite a textbook case of a monopoly. When hospitals have bought up local rivals, knocking out their competition, federal regulators have intervened to block these traditional mergers to protect patients from the resulting loss of competition. In recent years, they helped stop proposed mergers in New Jersey, Utah, and Rhode Island. The thinking is that without local competition, prices increase and the quality of care decreases.

It’s harder to prove how cross-market mergers, like the one planned in Missouri, reduce competition if the hospitals do not operate within a single market, said Chris Garmon, an assistant professor at the University of Missouri-Kansas City, who researches hospital mergers. Regulators would have to prove the mergers don’t just raise prices but also run afoul of the law by suppressing competition.

“That’s why we haven’t seen a cross-market merger challenge yet. It’s because it’s hard to tell the story of why this would be a problem,” he said.

The Federal Trade Commission did not answer questions from KFF Health News on its broader strategy around such deals or the BJC-Saint Luke’s merger. Whether an investigation is underway is not public information, said Mitchell Katz, an agency spokesperson.

After the FTC didn’t stop cross-market hospital mergers in California and Michigan, those states landed poles apart in handling the deals. California won concessions after challenging a deal, while Michigan did not intervene.

The FTC did closely examine the 2020 deal in Michigan between Spectrum Health, based in Grand Rapids, and the Detroit area’s Beaumont Health. Still, it ultimately didn’t oppose the marriage that created the state’s largest hospital chain, Corewell Health, with 22 hospitals in regions more than 150 miles apart.

The lack of intervention frustrated some, including Bret Jackson, CEO of the Economic Alliance for Michigan, a nonprofit that helps employers wrangle health costs. Spectrum was already the more expensive operator, said Jackson. He worries Beaumont prices will rise to match Spectrum’s once the insurance contracts with the individual hospital systems expire.

“They’re not going to want to take a pay cut,” Jackson said of Spectrum. “We’re really concerned about it.”

Jackson said that he was already fed up with rising hospital prices and that so are the automotive companies and laborers he represents. Health costs consume about 10% of a typical U.S. family’s income.

Ellen Bristol, a Corewell Health spokesperson, did not address KFF Health News’ questions about patient costs but said that the collaboration is improving quality statewide and creating efficiencies that help the company navigate economic headwinds.

Even though regulators did not step in, FTC staffers and Michigan’s Department of the attorney General volleyed emails back and forth for months, according to communications obtained by KFF Health News through a public records request from the state.

The FTC asked the attorney general’s office to connect its staffers to employers and state officials, plus provide information and data on the health care landscape in the state, the emails show. The FTC interviewed executives from BorgWarner, an automotive supplier, and CMS Energy, a utility company.

Jackson said he, too, was interviewed by the FTC, which he said was less interested in his thoughts on the deal than in Michigan’s market dynamics.

Story continues below video

It’s hard to glean much from the FTC’s assessment of the merger because many of the emails the state supplied to KFF Health News are redacted. But they do illustrate what information and which people the FTC consulted to reach a decision.

The emails also suggest state officials were made aware of the FTC’s findings. On the evening of Jan. 13, 2022, an assistant AG sent a lengthy email to Michigan attorney General Dana Nessel about the FTC’s review of possible antitrust implications, according to the subject line. In the version provided to KFF Health News, though, the entire email — except for the greeting and the signature — was blacked out.

The next day, other emails show, hospital officials began discussing final language with the AG’s office for a press release announcing the deal would soon close.

Michigan did not move to block the deal or investigate further. Danny Wimmer, a spokesperson for Nessel, a Democrat, said the deal fell outside the authority of her office, further frustrating Jackson, of the Economic Alliance for Michigan.

“We need to give state regulators the tools to at least assess mergers in the health care system,” Jackson said.

Nessel’s position is not the attitude taken in all states. A 2020 merger agreement in California between Huntington Hospital in Pasadena and Cedars-Sinai Health System, with its flagship hospital in Los Angeles, attracted the attention of then-state attorney General Xavier Becerra, who imposed conditions, such as price caps to protect consumers.

Becerra, a Democrat who is now Health and Human Services secretary, had argued the cross-market merger would lead to higher prices.

Employers relied on having both Cedars-Sinai and Huntington Hospital in their networks to ensure adequate access to all employees scattered across the massive Los Angeles region — with a population larger than that of most states — which California officials said has several distinct markets serving patients. If the two were to combine, employers would have to accept price hikes to maintain access to both entities, according to an analysis the AG’s office commissioned. Health systems can “threaten to create important holes in a health plan’s provider network,” the analysis said, by refusing to include all hospitals, giving the system greater leverage to extract higher prices from the health plan.

Cedars-Sinai and Huntington sued the AG over the conditions imposed on the merger.

Ultimately, the parties settled on revised conditions, which included a 10-year ban on all-or-nothing contracting with insurers and a cap on price increases for five years.

The settlement allowed Cedars-Sinai to expand access while reflecting a shared goal of “keeping healthcare affordable,” said Duke Helfand, a spokesperson for Cedars-Sinai. Still, it was considered a win for antitrust enforcers, with implications that could reverberate across the country, some health economists said.

In Missouri, the key question is whether state officials will intervene. attorney General Andrew Bailey, a Republican, is reviewing the merger, which requires his office’s approval before it can close, said Madeline Sieren, a spokesperson for the AG.

Neither BJC nor Saint Luke’s answered questions from KFF Health News about potential price increases or plans to improve quality. The hospitals have estimated the merged system will generate annual revenue topping $10 billion.

The Missouri systems ought to explain how this merger will benefit patients by lowering costs and improving quality, Garmon said.

“Whether they actually do them or not depends on whether they actually have the incentive to do them,” Garmon said.

This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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NATIONAL COLUN: Trump and his minions just keep shoveling | Opinion

attorneylegalcounsel99 — Sun, 17 Sep 2023 09:39:58 +0000

Time was when getting caught in a malicious lie about a rival would have ended an American politician’s career. We no longer live that way. Just the other day, Donald Trump unleashed a torrent of falsehoods attacking President Joe Biden that would have shamed a carnival barker.

Speaking to a rally in South Dakota, Trump delivered a series of mocking claims, beginning with the allegation that the administration was using made-up jobs numbers: If you ask Trump, only 2.1 million jobs have been created during the president’s 30 months in office. The actual statistics show somewhere over 13 million jobs — along with near-record growth in GDP (Gross Domestic Product) during the recovery from the 2020 COVID slump.

Then Trump got personal. “He makes up these stories, like there’s a picture of a fighter jet … [mocking] ‘I used to be a fighter jet pilot.’ Then there’s a picture of a truck. ‘I used to drive a truck.’ The worst is, did you ever see his golf swing? He said he’s a 6-handicap! A 6-handicap is a good golfer. This guy can’t hit a ball … I think that’s the greatest lie of all, if you want to know the truth.”

Trump shakes his head in feigned disbelief as the crowd laughs and applauds. (Never mind that there’s a bestselling book by veteran sportswriter Rick Reilly called “Commander in Cheat: How Golf Explains Trump,” describing how he races down fairways in his golf cart, kicks opponents’ balls into ponds, drops his own onto the green, etc. Filled with interviews of golf pros and caddies, it’s actually quite funny.)

So is Trump’s performance, or it would be if you didn’t know — South Dakota isn’t exactly a golfing hotbed — that every single word of it is a malicious lie. Biden has never claimed to be a truck driver or a fighter pilot. Don’t you think you’d have heard?

Biden has mostly made self-deprecating jokes about his golf game, commenting that “the course record remains intact” after his initial outing as president. Back in 2018, he carried a USGA handicap of 6.7, according to Golf News Net, which is pretty good — no surprise, as Biden was an accomplished athlete as a young man. But he’s never boasted about it.

Anyway, who cares? As a politician, Trump himself is treated by audiences and reporters alike as a stand-up comic, which would be fine if he stuck to stage performances. Alas, polls show that millions of gullible Americans believe even the most absurd of his inventions. Deep-thinking pundits are writing columns about Biden’s great unpopularity, which reality-oriented blogger Kevin Drum shows is largely a function of false memories.

I like Drum because he’s an engineer by training who lives in Orange County, California, and he’s congenitally immune to inside-the-Beltway conventional wisdom. Recently he posted a graph comparing the favorability ratings of the last several presidents at the equivalent points in their respective administrations. It turns out that they all hovered in the 40s. It comes with the territory. Biden’s in no worse shape politically than Clinton, Obama or Trump.

Only George W. Bush, thanks to the strong patriotic surge in response to the 9/11 terrorist attacks, was in better shape. However, Dubya’s disastrous second term drove his approval down to 24% by 2008.

So, no, President Biden isn’t deeply unpopular with the public, and certainly not in comparison with Trump, whose negatives are markedly worse even in Fox News surveys. That said, polls mean very little at this point in the election cycle and have largely failed to predict the results in any of the last several national contests.

Remember the vaunted “red wave” in 2022? Never happened. People don’t answer their phones anymore unless they know who’s calling. The whole business of public opinion polling is an increasingly shaky enterprise.

I suspect it’s the same with the Fox News-generated Hunter Biden saga. Supposedly, a majority of Americans believes Joe Biden has violated the law in his dealings with his wayward son. Apart from not paying his taxes on time, however, it isn’t even clear what crimes the younger Biden is alleged to have committed. It’s not against the law to work for a foreign corporation, nor to drop Daddy’s name in business meetings.

If it were, there wouldn’t be a Trump in-law walking around free, much less cashing humongous checks from Saudi Arabia.

Doting father that he is, I quite doubt that Joe Biden fills out Hunter’s IRS form 1040. Nor that after decades in public life with no sign of financial impropriety, he suddenly got greedy in his 70s.

However, the Fox News imagineers appear to have persuaded millions of viewers that with all the manure they’ve shoveled, there must be a pony.

Gullible cynicism regarding politicians is always tempting. But if they go ahead and impeach the president, they’d damned well better produce that pony.

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Three state attorneys general stoked partisan flames, ignoring signs of fraud

attorneylegalcounsel99 — Mon, 13 Mar 2023 05:44:19 +0000

By the Editorial Board

Where were three successive Missouri attorneys general as a medical insurance entity here was allegedly ripping off its customers all over the country for years? Federal authorities earlier this year finally shut down the Missouri-based Medical Cost Sharing Inc. But complaints about the company had come to the state attorney general’s office as early as 2017, when Josh Hawley held the post. Those complaints elicited vague assurances that Hawley’s office was “mediating” the issue. Two attorneys general later, the response is the same shrug-off.

Perhaps Hawley and his successor, Eric Schmitt, were both too busy with national ideological crusades designed to get them both to the U.S. Senate. Current attorney General Andrew Bailey — apparently having learned well from his fellow Republican predecessors — is now busy meddling with school policies that don’t even fall under his purview but are great outrage fodder for the right.

As The Kansas City Star reported, Medical Cost Sharing Inc. was essentially a health insurance company. Members paid premiums in exchange for the promise that any future medical bills would be covered — but under the auspices of a Christian-focused nonprofit.

The Justice Department alleges that, using various excuses, the organization routinely refused to pay claims for long-time members who had in some cases been paying as much as $750 a month in premiums for years. Many were left holding five-figure medical bills as the company’s owners pocketed millions. Following FBI raids of the company in December, a judge in January issued an injunction freezing the company’s finances pending further investigation.

The allegations, around for years, sound custom-made for action from the Missouri attorney general, the state’s top legal official. But Hawley, who won the office in 2016 with a campaign decrying “ladder-climbing” by politicians, was busy climbing toward the Senate (in large part, ironically enough, by joining a partisan lawsuit against the federal government that would have limited Missourians’ health care options).

After Hawley left for Washington halfway through his term, Schmitt stepped in and began filing showy lawsuits against Missouri school districts, China and others over pandemic issues, while doing nothing substantive to confront the alleged insurance fraud happening under his nose. Now that Schmitt, too, has ladder-climbed to the Senate, Bailey is directing the power of his office at non-issues like a silly controversy over a drag show during a school diversity event in Columbia.

As for the fraud victims, Bailey’s office says he’d “be happy to look into their specific complaints.” How big of him.

So it took the feds to do the job that three Republican state attorneys general couldn’t be bothered with, because they were too busy feeding red meat to the base. What a perfect illustration of how ill-served Missourians are by an important office that seems more focused on electioneering than upholding the law.

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Three state attorneys general stoked partisan flames, ignoring signs of fraud

attorneylegalcounsel99 — Mon, 13 Mar 2023 02:07:13 +0000

By the Editorial Board

As for the fraud victims, Bailey’s office says he’d “be happy to look into their specific complaints.” How big of him.

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Three state attorneys general stoked partisan flames, ignoring signs of fraud

attorneylegalcounsel99 — Sun, 12 Mar 2023 22:27:24 +0000

By the Editorial Board

After Hawley left for Washington halfway through his term, Schmitt stepped in and began filing showy lawsuits against Missouri school districts, China and others over pandemic issues, while doing nothing substantive to confront the alleged insurance fraud happening under his nose. Now that Schmitt, too, has ladder-claimed to the Senate, Bailey is directing the power of his office at non-issues like a silly controversy over a drag show during a school diversity event in Columbia.

As for the fraud victims, Bailey’s office says he’d “be happy to look into their specific complaints” How big of him.

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