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In Stanford Health Care v. Beth Minor, et al (Case No. 18CV330068), Stanford Health Care and Palo Alto Medical Foundation petitioned the Santa Clara County Superior Court to remove Measure F from the ballot. On August 1, Judge Mark Pierce rejected Stanford’s preemption argument, holding that “petitioners have not made a compelling showing for interfering with the initiative power.”[34] He ruled that both the Knox-Keene and the ACA refer to the regulation of health care service plans, while Measure F regulates costs charged by providers.[35] As such, neither Knox-Keene nor ACA preempts Palo Alto’s Measure F.

 Palo Alto’s Measure F:  November 2018 

Stanford vehemently fights to suppress all evidence of its habitual false billings and upcoding and unbundling.  Measure F is a manner in which to make Stanford's false billing conduct more transparent and protect the public from Stanford's decades of heath care fraud and abuses.

Stanford employs 300 billers for medical services which include an approximately 600  bed hospital. Those numbers don't make sense as 300 billers is an astronomical number of "hired guns" to make false claims by Stanford for unjust enrichment and unearned health care dollars.

Transparency of the following information is in the public interest. For example,  the March 26, 2018 U.C. Berkely Report’s 6-year study on northern California healthcare demonstrated the unconscionable costs in the area including Palo Alto and Stanford. However, the Report fails to elucidate an important aspect of the cost basis which is elucidated here.

Stanford achieves its much, much higher than average  or in many cases double or triple revenues for the same health care services through deliberately fraudulent means. For example, Stanford bills  2 or 3 units for a surgical supply as tens of thousands of dollars when in fact it used only 1 unit, or none at all. As another example, Stanford block bills time for its anesthesia services such that much higher than allowed fees are collected. As another example, Stanford bills services by its physician assistants, nurse practitioners, or unlicensed staff as doctor and surgeon time thereby achieving unjust enrichment. 

According to published research, Stanford Health Care charges “264% more than the statewide average to treat patients for alcohol or drug abuse, 142% more to treat patients with chest pain, and 121% more to treat patients with kidney failure,” and has about “$700 million in reserves.”  Becker’s Hospital Review article  noted that Stanford Health Care had an operating income of $74.3 million in the first quarter of fiscal year 2018, up from an operating income of $28 million in the first quarter of fiscal year 2017.

The Berkeley Report summates that healthcare within Stanford’s purview (in the northern part of the State)  is simply several fold higher in costs for the same services than in the southern part of the state. In analogy, the Report intimates that a "BigMac" costs $10 at Stanford Hospital while the same "BigMac" costs $3.33 in a Southern California Hospital. 

 

However, Stanford's Medicare and commercial billing data analysis  
elucidates that the issue is not the cost of each service that is at issue, but rather Stanford’s willful and habitual, institutional  upcoding and unbundling patterns.

 

Whereas the Berkley Report interprets that a BigMac costs $10 in Northern California, true Stanford billing data illustrate that a BigMac costs a maximum of $3.33 throughout the State.  This is based on the fact that  simple pricing of a product or service can not be the  true basis of full costs, because Medicare and carrier “allowables” for the same CPT codes are relatively the same across the State with minor differences of a few dollars. 

In simple analogy to healthcare, a BigMac still costs $3.33 in the entire State, but in Northern California (namely Stanford), Stanford collects unjust enrichment of $10 for one BigMac, by  unbundling  and upcoding to show work product and support false charges for 3 "BigMacs", or in some cases  1 "BigMac", fries, and a coke whereas only 1 "BigMac" was actually provided.  

 

Measure F Palo Alto

Measure F Palo Alto Letter from City Attorney

 

Measure F Palo Alto Summary