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Michigan Congressmen Introduce Bill Permitting Healthcare Providers to Negotiate Collectively with Health Insurers

On January 6, two Michigan Congressmen – Representative John Conyers (D-Mich.) and Representative Dan Benishek (R-Mich.) – introduced the “Quality Health Care Coalition Act of 2015.” The bill (H.R. 105) would permit...more

Anatomy of a Provider-Merger Antitrust Challenge (Part 3)

This is the third in a six-part series discussing the Federal Trade Commission's challenges to provider mergers. Following the initial Introduction and Background (Part 1), the series discusses The Need for Early Legal Advice...more

Insurer’s Agreements with Providers Are Not Per Se Antitrust Violations

The Iowa Supreme Court refused to categorize a health insurer’s agreements with providers in Iowa and its participation in the national Blue Cross and Blue Shield (BCBS) network as per se violations of the antitrust laws. ...more

Takeaways From the FTC/DOJ Workshop on Health Care Competition

The Federal Trade Commission and Department of Justice Antitrust Division held their second public workshop on health care competition on February 24-25, 2015. The workshop is part of the FTC and DOJ’s commitment to...more

Supreme Court Holds State Regulatory Board Not Immune From Antitrust Laws

On February 25, 2015, the U.S. Supreme Court determined that the North Carolina State Board of Dental Examiners (“Dental Board”) is not shielded from federal antitrust law under the doctrine of state-action antitrust...more

Illegal Premerger Coordination Leads to DOJ “Gun Jumping” Enforcement Action and $5 Million Settlement—Key Lessons Affecting...

On November 7, 2014, the Antitrust Division of the U.S. Department of Justice (“DOJ”) reached a $5 million settlement with Flakeboard America Limited (“Flakeboard”), its foreign parents, and SierraPine to settle allegations...more

Medical Billing Provider and its Former CEO Settle FTC Charges That They Misled Consumers About Collection of Personal Health Data

In an age when many of us briskly scroll through website terms and conditions and check, “I agree” without thinking, how should businesses design their websites to obtain proper authorization to access users’ sensitive...more

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

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

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

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

Implications on Pharmacies of Recent OIG Advisory Opinion on Per-Fill Fees

The U.S. Department of Health & Human Services, Office of Inspector General (OIG) recently issued an advisory opinion regarding a proposed arrangement by a specialty pharmacy (Requestor) to pay local pharmacies a per-fill fee...more

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

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

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

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

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

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

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

Appeals Court Upholds FTC Merger Challenge

On April 22, 2014, the U.S. Court of Appeals for the Sixth Circuit affirmed a decision of the Federal Trade Commission (FTC) finding that the merger of two hospital systems in Ohio violated the antitrust laws. ProMedica...more

Insurance Antitrust Legal News - May 2014 • Volume 3, Number 3

In This Issue: - LEGISLATION PERMITTING HEALTHCARE PROVIDERS TO NEGOTIATE JOINTLY WITH HEALTH INSURERS INTRODUCED IN CONGRESS: Legislation was recently introduced by Representative John Conyers (D. Michigan)...more

Expect Focus On Antitrust Issues In The Health Care Industry

There have been a number of high profile antitrust cases brought against health care providers, and the increasing interest of both the Federal Trade Commission (FTC) and plaintiffs should be considered in any proposed...more

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