Scripps “strongly objects” to the accusations, company spokesman Don Stanziano said yesterday. “Scripps is proud of our service to the community.”

He said the class-action designation, made Wednesday by Judge Steven Denton, did not represent a decision on the appropriateness of the bills under scrutiny. The ruling allows the plaintiff's attorneys to represent all the uninsured patients who might have been affected by the hospitals' practices.

“What happened today was expected. It's part of the process,” Stanziano said.

The case is similar to other suits filed in recent years in California and other states alleging that nonprofit health care systems such as Scripps have failed to live up to their legal obligation to provide free care to the needy in exchange for a tax-exempt status.

In the most recent case in California, Catholic Healthcare West agreed to pay $423 million in refunds and bill reductions to hundreds of thousands of uninsured patients who received care at the nonprofit's 35 hospitals in California. The San Francisco-based health care system did not admit any wrongdoing.

The Scripps case was filed last year by Franklin, of Solana Beach, who was referred to a collection agency after failing to pay a $2,900 bill for a visit to the emergency room at Scripps Memorial Hospital Encinitas in October 2004. Franklin was unemployed at the time because of a work-related disability and couldn't pay the charges, Dermody said.

Franklin went to the hospital with severe kidney pain and was diagnosed with a kidney stone. He was given urine and blood tests, a CT scan and pain medication, according to the suit, and was referred to a urologist.

The hospital was unwilling to let Franklin pay his bill in installments, Dermody said. The bill collector that later pursued the charges filed a lawsuit against Franklin in January 2006.

The rates at which Scripps bills uninsured patients – known as chargemaster prices – were, on average, 412 percent above the rates the hospitals charge when caring for patients covered by Medicare, the federal government's health care program for people who are elderly or have disabilities, according to the suit.

Government and private health plans routinely negotiate discounts for hospital services by using the leverage of being able to direct large numbers of patients to health care providers.

A recent article in the journal Health Affairs found growing evidence that uninsured patients are being charged considerably more – often as much as two and a half times – for hospital services than those with insurance.

The trend is a dramatic reversal from conditions 50 years ago when the poor and uninsured were often charged the lowest prices for medical services, wrote article author Gerard Anderson, a professor of health policy and management at Johns Hopkins Bloomberg School of Public Health in Baltimore.

Stanziano said that Scripps already offers a number of options for uninsured patients who need help paying their bills, including extended payment plans and discounts for those making less than 350 percent of the federal poverty rate or $72,275 a year for a family of four.

In 2005, the lawyers won what Gains calls the liability phase of the case, in which U.S. District Judge David D. Dowd Jr. sided with the inmates and took control of the lockup.

Generally the losing party in a case pays the winning party's legal fees.

The county's insurance company, the County Risk Sharing Authority, also known as CORSA, paid the legal fees associated with the liability phase, Gains said.

But CORSA argued it shouldn't responsible for the fees associated with the consent agreement, Gains said, and he agreed to assign his staff to represent the county in that matter and to pay Armbruster and Kelly's fees.

Panetti has been on Death Row in Texas since 1995 and has been diagnosed as schizophrenic.

Panetti's lawyers and attorneys for the state said he was mentally disturbed. The question was whether he was sufficiently mentally ill that it would violate the 8th Amendment, which bars cruel and unusual punishment, to execute him.

Panetti was hospitalized for mental illness 14 times in the decade before using a shotgun to kill his former in-laws in the Texas hill-country town of Fredericksburg, as his estranged wife Sonja and her son watched.

Panetti was ruled mentally competent to stand trial, to represent himself and to be executed. Before Thursday's decision, four courts, including the 5th U.S. Circuit Court of Appeals, rejected pleas by Panetti's lawyers to spare his life.

The case presented a particularly thorny question, because evidence was introduced that Panetti was aware that he had killed Amanda and Joe Alvarado. But expert testimony was presented that Panetti, known as "the Preacher" on Death Row, believed he was going to be executed because Texas was conspiring with the devil to block him from preaching the Gospel to fellow inmates -- not because of the Alvarado murders.

Kennedy found that Panetti's execution would be inconsistent with a 1986 Supreme Court decision that a person should not be put to death if he could not perceive "the connection between his crime and his punishment."

He was joined by Justices John Paul Stevens, David Souter, Ruth Bader Ginsburg and Stephen Breyer.

Dissenting was Justice Clarence Thomas, joined by Chief Justice John Roberts Jr. and Justices Antonin Scalia and Samuel Alito Jr.

The Supreme Court sent the case back to a federal judge in Austin, Texas, to reassess Panetti's mental health in light of the decision issued Thursday. Ted Cruz, the Texas solicitor general, said he would continue to press for Panetti's execution.

The high court's decision was hailed by the National Alliance on Mental Illness, which submitted a friend-of-the-court brief, as did the American Psychological Association and the American Psychiatric Association.

"For once, law has caught up with medical science," said Ronald Honberg, NAMI's director of policy and legal affairs.

"The circumstances of this case are tragic. ... However, execution of someone who is profoundly ill would only compound the original tragedy and represent a profound injustice for us all," Honberg said.

Under the terms of the settlement, Sony will pay $8.5 million in overtime wages to current and former employees, and will also "reclassify class members with a job title of Associate Artist and Artist 1 as nonexempt employees under the wage and hour laws of California and the federal Fair Labor Standards Act."

In spite of the settlement, Sony has denied the allegations in the suit and has admitted no liability or wrongdoing. According to a statement from the law firm, the settlement is conditional, "contingent upon court approval, and the settlement may be rescinded if a sufficient number of class members opt out of the settlement."

Frederick J. Lewis, a founding partner of Lewis Fisher, said he feels the joining of the two firms will add tremendous opportunities for Lewis Fisher as well as the Memphis business community. "I think (the combination will help Memphis companies) in the same way we see our firm as benefiting - it gives the resource of having a firm with 365 lawyers and 30 different offices across the country," Lewis said. "We serve clients across the country, but this obviously increases our ability to do that. It gives us depth.

"As far as the Memphis market, it gives clients in Memphis an opportunity to call on the resources of a nationwide firm when they have a case that calls for that."

Southern presence

The attorneys of Lewis Fisher will have the benefit of Ogletree Deakins' reputation that comes from representing more than half of the Fortune 50 companies in the United States, entities such as Home Depot, Dillard's, Nissan, Dollar General and Dell Corp.

Twelve attorneys from Lewis Fisher's Memphis office and seven from its Jackson, Miss., office will make up the first Ogletree Deakins offices in each city. Lewis, Thomas L. Henderson, Whitney King Fogerty, Charles V. Holmes, O. John Norris III and Craig A. Cowart will open the Memphis office as shareholders of Ogletree Deakins. Donna K. Fisher, a founding partner of Lewis Fisher, will join in an of counsel position.

Lewis Fisher, which began operating in 1998 in its current form, already had two attorneys operating out of an office in Los Angeles, so those attorneys will move into the L.A. office of Ogletree Deakins.

The Memphis office will become Ogletree Deakins' second office in Tennessee. The firm opened an office in Nashville in 1986.

Firm shareholder Kevin Frazier, who works out of Ogletree Deakins' Nashville office, said the firm was interested in Lewis Fisher for a number of reasons.

"The first attraction was the quality of the lawyers. When we are looking at cities, that is the first thing we look for," said Frazier, who is on the executive committee of Ogletree Deakins.

The marriage of the two firms also gives Ogletree Deakins a presence in a region that it would otherwise not have had access to before. Offices in Memphis and Jackson, Miss., offer exactly that for Ogletree Deakins, Frazier said.

"I have known Tom (Henderson) and Fred (Lewis) for probably 10 years, and have always been interested in doing something with them, and the opportunity just presented itself," Frazier said.

Only a matter of time

For Ogletree Deakins, combining with Lewis Fisher was part of the firm's overall strategy to address some of the current trends in the area of labor and employment law, Frazier added.

While Lewis Fisher attorneys had crossed paths with attorneys at Ogletree Deakins for years on various cases, Lewis said it was not until recently that the two firms began to talk about combining their resources.

Lewis and Henderson, who is a partner at Lewis Fisher, were in Nashville working on a case that also involved some Ogletree Deakins attorneys. They went to lunch one day after court and discussed the possibility of working together.

"We obviously had a productive lunch," Lewis said of that February meeting. "It has been a quick courtship."

One of the main reasons Lewis said his firm was interested in working with a firm as large as Ogletree Deakins was the trend in labor and employment law for cases to be filed as class actions. That trend opens companies such as the ones Ogletree Deakins represents to more liability than before.

Another trend in labor and employment that makes the combination of firms work well is that major corporations have begun to severely restrict the number of law firms they use, meaning companies that might have at one time used 20 law firms around the country, might only use two or three firms now.

"What that does for Lewis Fisher and their client base is it gives them an opportunity to say, 'We can do your work at 30 different locations with quality lawyers we know at one firm,'" Frazier said.

Ogletree Deakins already has begun to see the benefits since news of the combination became public earlier this month. The firm has picked up three lawsuits through Ogletree Deakins contacts in Memphis that it would not have been able to get without the office here, Frazier said.