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Judge’s Order to Unwind Hospital’s Acquisition of Physician Group Tests Boundaries of Antitrust Laws and the Affordable Care Act

A federal judge’s recent order to unwind the acquisition of Saltzer Medical Group, an independent physicians group, by St. Luke’s Health System, Ltd., a hospital system with its own staff of physicians, presents challenges...more

Medicaid Regional Care Organizations – Turning The Clock Back Twenty Years

Physicians who were practicing in the 1990s were involved in numerous attempts to organize themselves in order to be able to participate in and even financially survive the onslaught of managed care delivery systems. The new...more

Norman Physician Hospital Organization — Factors Supporting Clinical Integration

Clinical integration is a somewhat imprecisely defined concept in the health care industry. Lawyers and health care executives have identified components and elements of clinical integration and frequently ask how many of...more

The Sunshine Act: Putting It into Practice – Interview with Karen Lovitch, Member, Mintz Levin [Video]

Attorney Karen Lovitch, Practice Leader of Mintz Levin's Health Law Practice, discusses the challenges facing pharmaceutical and medical device manufacturers in complying with the Sunshine Act....more

FTC Again Confirms That Antitrust Law Encourages ACO Formation

Once again, the staff of the Federal Trade Commission (FTC) has rebutted calls by physician groups that state legislation is needed to allow independent physicians to collaborate....more

FTC's Norman PHO Advisory Opinion - New Clinical Integration Guidance, Same Antitrust Analysis

The Federal Trade Commission (FTC) provided its first guidance for clinically integrated networks since passage of the Affordable Care Act (ACA) and the joint FTC/DOJ Accountable Care Organization (ACO) Antitrust Policy...more

FTC Issues Favorable Clinical Integration Advisory Opinion to Norman, Oklahoma PHO

Since the passage of the Affordable Care Act (ACA), much attention has been paid to the antitrust treatment of Accountable Care Organizations, provider ventures contemplated by the ACA that the Federal Trade Commission and...more

It's Your Business Newsletter -- December 2012

In This Issue: ..Export Controls: Increased Enforcement Demands an Effective Export Compliance Program - United States exporters are subject to an extremely complex and often overlapping system of export...more

Can a Hospital Alliance Constitute a Single Entity for Antitrust Purposes? It Depends, Says One District Court

On August 30, 2012, the U.S. District Court for the Southern District of Ohio denied a motion to dismiss a complaint that alleged a per se group boycott by a managing agent and its affiliated hospitals in violation of Section...more

Federal Trade Commission Settles with Healthcare Group over Recent Acquisitions of Cardiologists

On August 6, 2012, the Federal Trade Commission (FTC) agreed by a vote of 5-0 to enter into proposed settlements with Renown Health regarding that group’s recent acquisitions of two cardiology groups in Reno, Nevada. The...more

No Change in Course on ACA Federal Antifraud and Transparency Provisions

Healthcare companies should work to comply with current provisions and prepare for those that will be implemented in the near future. The U.S. Supreme Court's decision that the Patient Protection and Affordable Care Act...more

Essential Health Transaction Planning for Providers in Today’s Antitrust Enforcement Climate

Federal antitrust enforcement agencies continue to challenge transactions in the health industry that they view as anticompetitive. This newsletter provides an update on recent public comments by government officials...more

CMS Selects 27 ACOs

In another step toward implementation of Accountable Care Organizations (ACOs), on April 10, 2012, the Centers for Medicare & Medicaid Services (CMS) selected 27 ACOs in 18 states to participate in the Medicare Shared Savings...more

FTC Granted Preliminary Injunction Against OSF Healthcare System/Rockford Health System

The U.S. District Court for the Northern District of Illinois granted the request for a preliminary injunction by the Federal Trade Commission (FTC), pending a full administrative trial before an FTC Administrative Law Judge...more

Rockford Returns — Part II: Court Grants FTC’s Preliminary Injunction Against Hospital Merger to Preserve Status Quo for...

In 1989, the Antitrust Division of the United States Department of Justice (DOJ) successfully challenged a proposed merger between Rockford Health System (Rockford) and SwedishAmerican Health System (SwedishAmerican), two of...more

Federal Trade Commission Upholds Challenge to ProMedica’s Acquisition of St. Luke’s

On March 28, 2012, the FTC upheld the Administrative Law Judge (ALJ)’s December 5, 2011 administrative decision that required ProMedica to divest itself of St. Luke’s Hospital by a vote of 4-0. This case is part of a series...more

Volume to Value: Strategies for Maximizing Your Margins

In this presentation; •Review the Changing Health Care Landscape •Cornerstones Of the New Emerging Payment Models •Case Studies of New Reimbursement and Delivery Models •Panel Discussion Please see...more

FTC Successfully Challenges ProMedica-St. Luke’s Merger

On December 5, 2011, the FTC obtained an administrative decision that requires ProMedica to divest itself of St. Luke’s Hospital. The Administrative Law Judge (ALJ)’s 246-page opinion, which was released to the public on...more

Health Law Alert: Final ACO Antitrust Enforcement Statement Won't Deter Procompetitive ACOs

When the idea of ACOs was floating around prior to enactment of the Affordable Care Act last March, some groups and commentators argued that antitrust enforcement was likely to deter their formation. Some commentators simply...more

Beyond the Cover Story Part 2: The Final ACO Regulations - November 9, 2011 (Presentation)

In This Presentation: What Guidance is Available? What is an ACO? Application; Agreement; Governance; Leadership; Two Shared Savings Models; Shared Savings Payments; Appeals; Assignment of Beneficiaries; Fraud and Abuse;...more

No Mandatory Antitrust Review for ACOs

The Department of Justice and Federal Trade Commission recently issued their final "Statement of Antitrust Enforcement Policy Regarding Accountable Care Organizations Participating in the Medicare Shared Savings Program"...more

FTC/DOJ Remove Mandatory Antitrust Review for MSSP-Participating ACOs in Final Policy Statement

On October 20, 2011, the Federal Trade Commission and Department of Justice issued a final policy statement on accountable care organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP). Significantly,...more

Medicare Accountable Care Organizations: CMS Announces Final Rule

On November 2, 2011, the Centers for Medicare & Medicaid Services (“CMS”) issued the final rule establishing Accountable Care Organizations (“ACOs”) under the Medicare Shared Savings Program (“Final Rule”). This alert...more

Antitrust Enforcement Agencies Issue Final Guidance on ACOs - Part one in a series of client advisories focusing on the new ACO...

This is the first in our client advisory series on the recent regulatory activities concerning accountable care organizations ("ACOs"). The federal antitrust agencies issued the final statement of their antitrust enforcement...more

FTC/DOJ Final Policy on Accountable Care Organizations: Important Antitrust Issues Remain Uncertain for Healthcare Collaborations

The Federal Trade Commission (FTC) and Department of Justice (DOJ) (together, the Agencies) issued their final "Statement of Antitrust Enforcement Policy Regarding Accountable Care Organizations Participating in the Medicare...more

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