Insurance Antitrust & Trade Regulation

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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

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

Harper Review Panel only goes half way for insurers

In its final report released on 31 March 2015, the Competition Policy Review Panel (chaired by Professor Ian Harper) has maintained some of the draft competition policy recommendations that were supported by insurers, but did...more

Privacy & Cybersecurity Update - March 2015

In This Issue: - Dismissal in P.F. Chang’s Data Breach Case Shows Challenge Plaintiffs Face in Such Actions - Eleventh Circuit Court of Appeals Decision Underscores the Need to Evaluate Insurance Programs for Cyber...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

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

DOJ and FTC Announce Proactive Approach to Monitoring Post-Affordable Care Act Antitrust Compliance at Joint Workshop

On February 24 and 25, the DOJ and FTC held their second joint workshop to examine the state of health care competition in the United States. The workshop explored five main themes: early observations regarding accountable...more

Congress Begins With Renewed Efforts to Repeal Insurer’s Antitrust Exemption

Early into the 114th Congress, multiple bills have already been introduced that would repeal the insurance industry’s limited antitrust exemption granted by the McCarran-Ferguson Act (15 USC 1011 et seq.)....more

FTC and DOJ Host Workshop Examining Health Care Competition - Updated 2015

The Federal Trade Commission (FTC) and the Antitrust Division of the U.S. Department of Justice (DOJ) held a public workshop on February 24–25, 2015, to examine recent trends and developments in health care provider...more

Competition and Regulation Update: Health Sector Under ACCC Spotlight In 2015

ACCC ENFORCEMENT PRIORITIES - The Australian Competition and Consumer Commission (ACCC) has released its enforcement priorities for 2015, with the Chairman of the ACCC giving a speech on the topic last week. Each year,...more

Writing for Mealey's, Tom Bush Analyzes Antitrust Issues with Joint Underwriting

With insurance companies coming under increased scrutiny from government antitrust enforcers and the plaintiff antitrust class action bar, many companies are undertaking a reassessment of their practices for compliance with...more

Texas Court Holds No Duty to Defend Claims of Monopolistic Practices

In its recent decision in Uretek United States v. Cont’l Cas. Co., 2015 U.S. Dist. LEXIS 18610 (S.D. Tex. Feb. 17, 2015), the United States District Court for the Southern District of Texas had occasion to consider a general...more

Can A Certified Class Include Uninjured Parties? First Circuit Majority Says “Yes,” In Some Instances

One of the “hot” issues in class actions today is whether, or to what extent, a class can be defined to include members who were not injured, and do not have standing to sue. ...more

MDFL Dismisses Auto Repair Antitrust Claims, Eviscerates Plaintiffs’ Lawyers

In 2014, the Judicial Panel on Multidistrict Litigation consolidated a series of antitrust actions and transferred them to the United States District Court for the Middle District of Florida. The Middle District of Florida...more

Several Large Insurance Industry Mergers Announced as 2014 Comes to a Close

As 2014 came to a close, several significant insurance industry transactions were announced that, if completed, will likely reshape several segments of the insurance industry in 2015. Each of them, of course, will require...more

Insurance Antitrust Legal News: Volume 4, Number 1

Verisk/EagleView Merger Derailed by FTC Challenge - On December 16, Verisk Analytics, a leading provider of data analytics and related services to the insurance industry, including rooftop aerial measurement products,...more

CMA Forced to Backtrack on Hospital Divestments in Private Healthcare Market Investigation

The Competition and Markets Authority (“CMA”) has backed down from its decision in the Market Investigation into Privately Funded Healthcare Services (the “PH Investigation”), which required HCA to divest some of the private...more

Ask the Experts About Bad Faith; Just Be Careful How You Do It

In bad faith cases, juries must often decide if the way an insurer processed a claim lacked a “reasonable” basis. Courts have consistently held that experts can help—by explaining how a claim is supposed to be handled. The...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

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

European Antitrust “Block Exemption” For Insurance Under Review

In the United States, the McCarran Ferguson Act (15 USC 1011-1015), enacted by Congress in 1945, provides the insurance industry with a limited exemption from the federal antitrust laws. The Act applies to all conduct that...more

Insurance Antitrust Legal News: Volume 3, Number 5

European Antitrust "Block Exemption" for Insurance Under Review: In the United States, the McCarran Ferguson Act (15 USC 1011-1015), enacted by Congress in 1945, provides the insurance industry with a limited exemption...more

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