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Competition & Regulation Update: Good News For The Private Health Insurance Sector… But How Long Will The Wait Be?

In our update on 10 April 2015, we highlighted the key recommendations of relevance to the private health insurance industry contained in the final report of the Competition Policy Review Panel chaired by Professor Ian Harper...more

Anatomy of a Provider-Merger Antitrust Challenge (Part 6)

This is the concluding installment of 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...more

Iowa Supreme Court Affirms Ruling for Health Insurer in Antitrust Dispute

In late February, the Iowa Supreme Court affirmed a lower court ruling in Mueller v. Wellmark, ending a seven year battle over whether the health insurer’s agreement with employers operating “self-funded” insurance plans to...more

Insurance Antitrust Legal News: Volume 4, Number 3

Auto Insurers Again Seek Dismissal of In Re Auto Body Shop Antitrust Litigation - In early March, the auto insurer defendants in the In re Auto Body Shop Antitrust Litigation renewed their motions seeking the dismissal...more

All or Nothing: Federal Court Decides Exclusion from ‘Some’ Patients Insufficient for Refusal to Deal Claim

A federal district court in the Eighth Circuit dismissed claims brought against a physician-hospital organization and an insurer alleging that the defendants violated federal antitrust laws by refusing to deal with certain...more

ABA Antitrust Spring Meeting Highlight: “Antitrust & Health Care: Square Peg in a Round Hole?”

In this month’s American Bar Association (ABA) Section of Antitrust Law Spring Meeting, the program “Antitrust & Health Care: Square Peg in a Round Hole?” featured debate and discussion about antitrust law treatment of health...more

FTC Obtains $26.8 Million in Disgorgement to Settle Monopolization Claims

On April 17, 2015, the Federal Trade Commission (FTC) entered into a settlement with Cardinal Health, Inc. (Cardinal) to resolve allegations that Cardinal, the largest and in certain areas the sole operator of...more

Four Takeaways from the ABA Antitrust Section’s 2015 Spring Meeting

This year's 63rd ABA Section of Antitrust Law Spring Meeting featured extensive remarks from antitrust regulators forewarning of more vigorous antitrust enforcement in 2015. The Proskauer antitrust team was on the ground and...more

Cardinal Health Agrees to Settle Monopolization Claims

The Federal Trade Commission ("FTC") announced on April 20, 2015 that it had entered into a stipulated consent order ("Order") with Cardinal Health, Inc. ("Cardinal"). The Order, which is pending court approval, requires...more

Physician Non-Compete Agreements and Antitrust

Antitrust claims based on employee non-compete agreements generally fail because the plaintiff cannot establish antitrust standing. In the Eleventh Circuit, the test for antitrust standing requires the plaintiff show (1)...more

Third Circuit Remands Class Certification Ruling in Blood Reagents Price-Fixing Case

On Wednesday, April 8, 2015, the Third Circuit Court of Appeals vacated a district court’s order certifying a class of direct purchasers of blood reagents in a price-fixing suit against Ortho-Clinical Diagnostics Inc. In re...more

Competition & Regulation Update: Harper Review - Implications For The Private Health Insurance Industry

On 31 March 2015 the final report of the Competition Policy Review Panel chaired by Professor Ian Harper (Harper Review) was released. The Harper Review Panel (Panel) has completed the most comprehensive review of Australia's...more

Open Season on Provider-controlled Licensing Boards

In a closely followed decision with significant consequences for state licensing boards and their members, the Supreme Court in North Carolina State Board of Dental Examiners v. Federal Trade Commission, 135 S. Ct. 1101...more

“It’s Not Easy to Unscramble the Eggs” … Despite the FTC’s Win at the U.S. Supreme Court, the Phoebe Putney Hospital Merger...

Nearly four years after the Federal Trade Commission (“FTC”) first challenged the combination of the only two hospitals in Albany, Georgia, the FTC, Phoebe Putney Health Systems, Inc. (“Phoebe Putney”), Hospital Authority of...more

Non-Compete Nonsense: Louisiana Enforces Non-Competes Against Cardiologists (but not Car Dealers)

A recent case out of the Louisiana Court of Appeal reminds us that some states will enforce physician non-compete agreements, even in the absence of a clear protectable interest and even where such enforcement threatens harm...more

Hospital Wins First Round Against Largest Rival in Antitrust Suit Alleging Illegal Exclusive Dealing Agreements with Insurers

The waves of change affecting health care providers include reimbursement and funding developments, the impact of the Affordable Care Act, technological and medical advances, provider network design transformations imposed by...more

Federal Court Allows Hospital’s Antitrust Claims to Proceed on Narrow Market Definition

Winning an antitrust lawsuit hinges on defining the “relevant market,” and this case may prove the point. Methodist Health Services Corporation notched the first win in its battle against Saint Francis Medical Center as a...more

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

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