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Conspiracy? Ohio Federal Court Says No; Holds That Health System Joint Venture Is a Single Entity Incapable of Conspiring in...

When competing health care providers affiliate by contract, rather than by merger or acquisition, they often face the challenge of structuring their joint activities to avoid liability under § 1 of the Sherman Act, which...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

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

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

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

Federal Court Rejects Challenge to new CMS Recovery Auditor Contracts

On August 22, 2014, the U.S. Court of Federal Claims denied a challenge by incumbent Recovery Audit Contractor (RAC) CGI Federal, Inc. (CGI) to CMS’s plan to award new RAC contracts. Among other things, the Court found that...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

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

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

United States Supreme Court to Revisit State Action Doctrine

Which exercise of safeguarding the people will prevail: a State’s regulation of professionals providing services to its citizens, or the antitrust agencies’ protection of consumers against anticompetitive conduct? The United...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

Sixth Circuit Affirms FTC Order of Divestiture and Prohibits ProMedica Health System's Purchase of Competing Hospital

In an opinion published on April 22, 2014, the United States Court of Appeals for the Sixth Circuit sided with a Federal Trade Commission (FTC) decision that ProMedica Health System, Inc.'s acquisition of rival St. Luke's...more

Antitrust Hospital Merger Policy Gets a Judicial Boost — Sixth Circuit Upholds FTC Decision Challenging Hospital Merger

In a highly anticipated decision, the federal antitrust agencies’ reinvigorated hospital merger enforcement efforts received a boost when, for the first time this century, an appellate court upheld a Federal Trade Commission...more

Health Law Insights Newsletter

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

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