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New York Certificate of Public Advantage (COPA) Program Alert: Revised Regulations Are Particularly Relevant to DSRIP Participants

On August 27, 2014, the New York State Department of Health ("DOH") issued revisions to its proposed regulations implementing the Certificate of Public Advantage ("COPA") process, which will facilitate immunity for New York...more

New York Proposes Revised Regulations for Health Care Collaborations

Today, New York health regulators proposed revised rules that would allow health care providers to merge or cooperate with one another without being subject to federal or state antitrust scrutiny....more

Antitrust Considerations Surrounding Health Care Consolidation Among Hospitals and Physicians

The Affordable Care Act (“ACA”) has resuscitated the demand for hospital and health care provider mergers. The law explicitly encourages collaborative care—through, for example, financial incentives surrounding the creation...more

Don’t Pop the Cork Just Yet—Growing Criticism of Massachusetts AG’s Settlement with Partners Healthcare Just Might Send the...

After touting a proposed settlement with Partners HealthCare (Partners) that supposedly would “fundamentally alter [Partners’] negotiating power for 10 years and control health costs across [Partners’] entire network,”...more

Buckle Up—Unwinding Phoebe Putney’s Acquisition of Palmyra Down in Georgia May End Up Being Back on the Table

Almost one year ago, Federal Trade Commission (FTC) agreed to settle its antitrust challenge of Phoebe Putney Health System’s (Phoebe Putney) acquisition of Palmyra Medical Center (Palmyra) without requiring divesture or any...more

FTC Promotes Competition Among Professionals Through Advocacy, Enforcement

On July 16, 2014, Andrew Gavil, Director of the Office of Policy Planning at the Federal Trade Commission (FTC), testified on the subject of “Competition and the Potential Costs and Benefits of Professional Licensure” before...more

Driving Health Care Efficiencies through Consolidation: Despite Reforms, The Usual Rules Apply

With almost 18 percent of U.S. GDP spent on health care, experts see consolidation as fundamental to reducing costs—by integrating care coordination and delivery, and by increasing scale to drive efficiencies, including with...more

Partners Healthcare’s Settlement with Massachusetts Attorney General Put on Hold

On July 1, 2014, Massachusetts Suffolk Superior Court Judge Janet L. Sanders ruled that the tentative settlement reached between the state of Massachusetts and Partners Healthcare System (“Partners”) would be delayed. The...more

Insurance Antitrust Legal News - July 2014 • Volume 3, Number 4

In This Issue: - COURT DENIES BLUES’ MOTION TO DISMISS IN RE BLUE CROSS BLUE SHIELD ANTITRUST LITIGATION (MDL 2406): On June 18, United States District Court Judge David Proctor (Northern District of Alabama)...more

Let The Rejoicing Begin, Or Not—Massachusetts AG’s Settlement With Partners Healthcare Is No Harbinger of Things to Come

After almost half a dozen years of investigating Partners HealthCare’s (Partners) contracting practices and its proposed acquisitions of two competing hospital systems, Massachusetts Attorney General (AG) Martha Coakley...more

Antitrust and Health Care: An Update from the Federal Trade Commission

The interplay between the Affordable Care Act (ACA), Accountable Care Organizations (ACOs), and antitrust has been a matter of great moment for several years. It has been an issue in litigation such as the Federal Trade...more

The American Board of Obstetrics and Gynecology Reverses Its Unlawful Ban on Treating Male Patients

In September of 2013, the American Board of Obstetrics and Gynecology adopted a policy of excluding obstetrician/gynecologists from eligibility for Board certification and recertification if they treated any male patients....more

Loose Lips Sink Ships and Careless E-mails Torpedo a Transaction

Federal antitrust laws prohibit hospital systems, like other businesses, from using a dominant market position to exclude competitors and restrain trade. Recently, e-mail communications exchanged between a...more

Points & Authorities - Spring 2014

In this Issue: - AB 1000 and Corporate Practice in California: More than Meets the Eye—or Less? - Loose Lips Sink Ships and Careless E-mails Torpedo a Transaction - New Faces - Points from the...more

Enforcement Action – FTC Is Not Backing Down and Laboratory Company Goes After a Cyber-Intelligence Company

The Department of Health and Human Services (HHS) Office for Civil Rights (OCR) is not the only government arm that enforces data breaches. The Federal Trade Commission (FTC) has broad authority to regulate the security of...more

FTC Uses Its "Unfair Acts" Power to Go After PHI Security Breach

The Federal Trade Commission (FTC) is moving forward with an administrative action against a small medical laboratory that suffered two data security breaches, resulting in its patients’ protected health information falling...more

What the WTP? The Rise of Merger Simulation in Hospital Transactions

If you are a health system or hospital thinking about a potential transaction and your lawyers haven’t spoken with you about hospital merger simulation, then maybe you should be talking with someone else. What is...more

Collusion Regarding Terms of Medical Resident Employment?

Did you ever wonder why teaching hospitals can conduct their medical residency “match” program? And why they can share data and use it to help set wages for residents? And why the match program effectively forbids salary...more

Potential Risks of Healthcare Joint Ventures Between Insurance Companies and Hospitals

Healthcare joint ventures are nothing new. Since the mid-2000’s, physician-hospital ventures have been resurgent, notwithstanding the Office of Inspector General’s skepticism regarding the risk of fraud and abuse when...more

FTC Workshop Addresses New Data Privacy Issues Concerning Consumer Generated Health Data

On May 7, 2014, the FTC hosted the latest seminar in their Spring Privacy Series to address the status of Consumer Generated and Controlled Health Data and relate results of recent FTC studies on the topic. Consumers are...more

What the WTP?

If you are a health system or hospital thinking about a potential transaction and your lawyers have not spoken with you about hospital merger simulation, maybe you should be talking with someone else. What is hospital...more

Senate Bill No. 35: An Act Concerning Notice of Acquisitions, Joint Ventures and Affiliations of Group Medical Practices

At the end of the Connecticut General Assembly’s 2014 Regular Session, "An Act Concerning Notice of Acquisitions, Joint Ventures and Affiliations of Group Medical Practices" (the "Act") was passed and is awaiting the...more

Regulatory double jeopardy? FTC enforcement of privacy and security in healthcare

How should health care companies strengthen their HIPAA compliance programs to manage the risk of a potential FTC investigation? While the U.S. Department of Health and Human Services (HHS) Office for Civil Rights...more

Tennessee Insurance Legal News - May 2014 • Volume 3, Number 2

In This Issue: - COMMISSIONER OF TENNESSEE DEPARTMENT OF COMMERCE AND INSURANCE ISSUES POSITION ON FILING REQUIREMENTS OF NEW ENTERPRISE RISK FILING LEGISLATION: On May 28, 2014, Governor Haslam signed...more

FTC Defeats Another Hospital Merger

The Federal Trade Commission’s (FTC) recent streak of successfully challenging hospital mergers under section 7 of the Clayton Act (15 U.S.C. § 18) continues. On April 22, 2014, the United States Court of Appeals for the...more

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