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GAO Takes Aim at GPOs

The GAO had drawn a bead on GPOs. In a report issued yesterday the Government Accountability Office expressed concern over the effect of GPOs (group purchasing organizations) on Medicare rates. The report recommended that...more

Insurance Antitrust Legal News - November 2014 - Volume 3 - Number 6

Plaintiff Files Third Amended Antitrust Claim Against Highmark - A long running antitrust dispute in Western Pennsylvania continued on October 1, when a Pennsylvania hotel (Cole’s Wexford Hotel) filed a third amended...more

Health Insurer Antitrust Claim Against Drug Company Remanded to State Court

Over the last several years, several health insurers have brought antitrust claims against drug companies, contending that they were overcharged for drugs as a result of agreements reached by the drug companies in the...more

District Court Weighs in on Level of Integration Required to Shield Health Care Collaborations from Section 1 Scrutiny

In Medical Center at Elizabeth Place v. Premier Health Partners et. al, Case No. 12-cv-26 (S.D. Oh. Oct. 20, 2014), the Southern District of Ohio held that previously-competing health care systems who join together in a...more

Ohio District Court Deems Hospital Alliance a Single Entity Incapable of Conspiring Under the Antitrust Laws

On October 21, 2014, the U.S. District Court for the Southern District of Ohio granted Defendants’ motion for summary judgment, holding that Premier Health Partners (“Premier”) and its affiliate hospitals, Atrium Health...more

When a state agency strays into antitrust liability: 4 practical tips about professional self-interest

Are you a practicing physician who sits on a state licensing board? Is your business affected by a state board with practicing physicians on it? If you said yes to either question, you should read on....more

FTC Competition Priorities

FTC Commissioner Julie Brill discussed the agency’s competition and consumer protection priorities in her keynote address last Thursday at the ABA’s Antitrust Fall Forum at the National Press Club in Washington. Brill led off...more

For Single-Enterprise Immunity, the Bottom Line May Be Having One Bottom Line

A federal court in Ohio has provided some of the clearest guidance to date on the application of the single-enterprise immunity doctrine to healthcare organizations. The single-enterprise immunity doctrine is critically...more

Licensing Boards Face Antitrust Laws

States rely heavily on licensing boards to “police” various professions and industries. In the past, these boards have been immune from antitrust claims. But a significant case is about to impact state licensing boards...more

Goliath Defeats David in Ohio Hospital Suit

On Monday the court unsealed its October 20 decision handing Premier summary judgment. Tiny Medical Center at Elizabeth Park (MCEP) had sued the Premier hospitals, alleging they had engaged in an antitrust conspiracy to keep...more

Dr. Reddy’s Laboratories Settles on Eve of Trial – Agrees to Cooperate with Plaintiffs

Much has happened since our last post on the Nexium “pay for delay” class action lawsuit. Jury selection began in the District of Massachusetts on Monday, October 20, 2014. The day prior, one of the generic drug makers, Dr....more

State Action Doctrine Tested by Supreme Court for Second Time in Two Years

After nearly two decades of silence on the state action doctrine, on October 14, 2014, the United States Supreme Court heard oral argument in the Court’s second case on the subject in two years: The North Carolina Board of...more

More Turns in the FTC's Antitrust Enforcement Action Against Phoebe Putney Hospital, Inc.

The FTC’s long-running campaign against Phoebe Putney Health System, Inc.’s acquisition of Palmyra Park Hospital, Inc., continues. In an unusual sequence of events, the Commission first conditionally accepted a Consent...more

Recent State Attorney General Merger Enforcement: Charting a Different Path from the Feds - or Not?

As hospital and physician consolidation continues, state Attorneys General (AG) have not abdicated the merger enforcement arena to the Federal Trade Commission (FTC) or the United States Department of Justice (DOJ)...more

Georgia Department of Community Health Ruling Jeopardizes FTC Action Against Phoebe Putney Health System, Inc.

On October 6, Ellwood F. Oakley III, an administrative hearing officer at Georgia’s Department of Community Health, reversed an initial staff determination that a new Certificate of Need (CON) would not be required if Phoebe...more

Supreme Court’s 2014-15 Term: Antitrust Case May Impact the Activities of Alcohol Industry Public/Private Organizations

On October 14, 2014, the United States Supreme Court heard oral argument in a case that could have significant implications for hybrid public/private “regulatory” bodies. Many such bodies, like state and local wine...more

Supreme Court Examines Boundaries of Antitrust Immunity in North Carolina State Board of Dental Examiners v. FTC

On October 14, 2014, the United States Supreme Court heard oral arguments in North Carolina State Board of Dental Examiners v. FTC, a U.S. Court of Appeals Fourth Circuit decision upholding an FTC finding that the North...more

FTC Attacks Toothless Regulation of Dentists

Yesterday the United States Supreme Court heard argument in a case of national importance to health professions and the state boards that regulate them. The case, North Carolina Board of Dental Examiners v. FTC, addresses...more

OIG Releases New Proposals on Anti-kickback Statute Safe Harbors, Exceptions to the CMP Law and the Gainsharing Prohibition

On October 3, 2014, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) published a long-awaited proposed rule for implementing amendments to safe harbors under the Anti-kickback Statute and...more

OIG Approves Yet Another Medigap Policy Contract with Preferred Hospital Network

On September 17, 2014, the U.S. Department of Health & Human Services, Office of Inspector General (OIG) issued Advisory Opinion 14-08 [PDF]. This opinion is yet another favorable advisory opinion approving a Medicare...more

Provider Competition Matters—Even for “Reference Pricing”

In a recent blog post, three Federal Trade Commission (FTC) economists splashed some cold water on advocates of “reference pricing” that seem to imply that such pricing “will increase competition between providers.” In the...more

Combating Unfair Competition: The Convergence of China’s Antitrust and Anti-Graft Enforcement Activities

Recent investigations and high profile convictions highlight the ongoing crackdown by China’s authorities against anti-competitive conduct. In their efforts to combat unfair competition, Chinese authorities have used both...more

Reverse Payments, Actavis, and the Lower Courts at Sea, Part 2: The Brewing Conflict Over Non-Cash Settlements

Our first post in this series was titled “What Is a Reverse Payment?” As the recent cases discussed in today’s post show, the courts are struggling with a fundamental component of that question: What, for that matter, is a...more

Focus on Regulatory Law - October 2014

In This Issue: - Regulatory Authorities - Energy - Public Economy Law - State Aid - Contract - Public Health - In Brief - Excerpt from Regulatory Authorities: French Competition...more

The Evolution of Efficiencies and Treatment of Quality of Care Defenses in Light of Changing Health Care Industry Dynamics

The consolidation of health care markets and the impact of this consolidation on prices, costs, and quality, has been a hotly debated topic in the health care industry. Hospitals across the country are merging and acquiring...more

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