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The Centers for Medicare & Medicaid Services (CMS) has extended the deadline for compliance with the two-midnight rule through September 30, 2014. The rule provides that if an inpatient stay crosses two midnights, the...more

State Action Doctrine At The Supreme Court: Take Two

The Supreme Court has a renewed interest in the state action doctrine. After declining to clarify what types of state action are exempt from federal antitrust scrutiny for years, the Supreme Court agreed to hear its second...more

FTC Successfully Challenges Non-Reportable Acquisition of Physician Group

On January 24, 2014, the U.S. District Court for Idaho held that St. Luke’s Health System (“St. Luke’s”)’s acquisition of Saltzer Medical Group (“Saltzer”), violated Section 7 of the Clayton Act and ordered St. Luke’s to...more

Insurance Antitrust Legal News - January 2014 • Volume 3, Number 1

In This Issue: - MISSISSIPPI GOVERNOR RESCINDS EXECUTIVE ORDER REQUIRING BLUE CROSS OF MISSISSIPPI TO GRANT “IN NETWORK” STATUS TO EXCLUDED HOSPITALS: In early November, Mississippi Governor Phil Bryant...more

Business Court Says "Rule Of Reason" Analysis Appropriate To Antitrust Claim By Chiropractors Against Their Independent Practice...

I can think of only three reasons why you might want to know about the Business Court's decision in Sykes v. Health Network Solutions, 2013 NCBC 53: - You are a chiropractor or you live with one. - You are...more

Insurance Antitrust Legal News - November 2013 • Volume 2, Number 6

In This Issue: - BILL SEEKING TO REPEAL THE MCCARRAN FERGUSON ACT’S ANTITRUST EXEMPTION INTRODUCED IN CONGRESS: On September 18, Congressman Phil Roe (R-Tennessee) introduced legislation (H.R.3121) that would,...more

In The Wake Of Phoebe Putney, New York Passes Law Giving Antitrust Immunity To State Health Care System

Earlier this year, the Supreme Court issued its decision in FTC v. Phoebe Putney Health System, Inc., 133 S.Ct. 1003 (2013), which held that the state action antitrust immunity doctrine applies only when the state legislature...more

Detroit District Court Certifies Antitrust Class of Registered Nurse

What is the right compensation for a particular job? That’s the question virtually every employer must face. Pay too little, and the employer may not be able to fill a position or must settle for less than the best...more

Bloomberg Law: Actavis Court Requires Case-by-Case Analysis of Anticompetitive Effects of Reverse-Payment Settlements

This article analyzes the US Supreme Court's recent antitrust decision in FTC v. Actavis, which held that that courts should apply the rule of reason in analyzing reverse-payment settlements. ...more

Justices say pay-for-delay deals with generic drug makers subject to antitrust 'rule of reason'

In Federal Trade Commission v. Actavis, the Supreme Court held 5-3 that trial courts must apply the traditional "rule of reason" to determine whether reverse-payment settlement agreements between Pharmaceutical Brand...more

Fourth Circuit Holds State Agencies Operated by Market Participants Are Private Actors for State Action Purposes

On May 31, 2013, the Fourth Circuit issued an opinion upholding the Federal Trade Commission’s (FTC) determination that the North Carolina State Board of Dental Examiners (Board) illegally expelled non-dentists from the teeth...more

NC Dentists Can’t Stop Competition from Other Providers of Teeth-Whitening Services

The North Carolina State Board of Dental Examiners (“Board”) failed to convince the United States Court of Appeals for the Fourth Circuit that the Board’s successful effort to “expel non-dentist providers from the North...more

Insurance Antitrust Legal News - May 2013 • Volume 2, Number 3

In This Issue: - STATE EFFORTS TO RESTRICT HEALTH INSURER USE OF “MOST FAVORED NATION” CLAUSES IN PROVIDER CONTRACTS CONTINUE TO MULTIPLY: Over the last several years, several states have considered legislation...more

No “Permission To Roughhouse In Market” Found: Supreme Court Unanimously Finds For The FTC In Opposing Hospital Acquisition

In an opinion that has implications for the health care industry and beyond, the Supreme Court, in Federal Trade Commission v. Phoebe Putney Health System, Inc., last month clarified the standard for exempting “state-action”...more

Supreme Court Limits State Action Immunity In Federal Trade Commission v. Phoebe Putney Health Systems

In a closely watched decision, a unanimous U.S. Supreme Court has reversed an 11th Circuit decision that invoked the state action doctrine to prevent the Federal Trade Commission (FTC) from challenging a state hospital...more

High court scales back antitrust exemption

This Daily Journal article analyzes the United States Supreme Court decision of Federal Trade Commission v. Phoebe Putney Health System, Inc, which held that a state's grant of general corporate powers to government entities...more

Supreme Court Reins in State Action Immunity

Last week a unanimous Supreme Court issued its highly anticipated opinion in FTC v. Phoebe Putney Health System, Inc., addressing the "State action" exemption from application of the federal antitrust laws for the first time...more

Merger-To-Monopoly Held Not Protected By State-Action Immunity

The U.S. Supreme Court on February 19th scaled back the "state action immunity" doctrine, siding with the Federal Trade Commission on an issue that had divided the lower courts and holding that a county Hospital Authority's...more

The Supreme Court Tightens Up State-Action Immunity: Justices Rule that Phoebe-Putney/Palmyra Transaction Is Not Immune from...

On February 19, 2013, the Supreme Court unanimously held that the effective acquisition of Palmyra Medical Center (“Palmyra”) by Phoebe Putney Health System, Inc. (“PPHS") in Southwestern Georgia was not immune from antitrust...more

Supreme Court Unanimously Rejects Antitrust Immunity in Hospital Merger Case

What you need to know: The Supreme Court issued a unanimous decision siding with the FTC against a hospital merger in Georgia. What you need to do: Companies should conduct careful analysis before...more

Supreme Court Clarifies Antitrust Immunity For State-Sanctioned Conduct

On February 19, 2013, the U.S. Supreme Court, in a unanimous decision, found that a merger of two Georgia hospitals was not immune from federal antitrust laws under the "state-action" exemption, reversing a decision of the...more

Supreme Court Holds Antitrust Law Applies to State Hospital Authority Transaction

In one of the most closely watched healthcare antitrust cases in years, the Supreme Court issued its decision in the FTC merger challenge to a Georgia hospital merger, Phoebe Putney Health System’s acquisition of Palmyra...more

Supreme Court Limits Availability of State Action Immunity from Federal Antitrust Liability

The Supreme Court decision in FTC v. Phoebe Putney Health System, Inc., makes clear that state action immunity from federal antitrust laws is disfavored, and local governmental, quasi-public and private entities can only...more

Cost-Shifting Mandatory when Non-Party Subpoena Cost of Compliance is “Significant”

In United States v Blue Cross Blue Shield of Michigan, the U.S. Department of Justice (DOJ) filed suit against Blue Cross alleging violations of federal antitrust laws. The DOJ issued non-party subpoenas to two hospitals...more

Insurance Antitrust Legal News - November 2012 • Volume 1, Number 4

In This Issue: - DOJ and FTC Hold Public Workshop to Consider the Antitrust Issues Raised by “Most Favored Nation Clauses” in Health Insurance Contracts by James M. Burns: On September 10, the Federal Trade...more

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