Insurance Antitrust & Trade Regulation

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DOJ Sues to Enjoin Two Large Health Insurer Mergers

In July 2015, health insurer mergers were announced between Anthem and Cigna and between Aetna and Humana. The effect of these mergers would elevate Anthem/Cigna to the #1 rank in size among national health insurers. ...more

Duty to Defend: Surplus Line Brokers and Professional Liability

Negligent solicitation and placement of insurance policies and failure to conduct due diligence into the admitted insurance market are covered under E&O policy - In a decision with significant implications for surplus...more

Mega-Mergers Highlight Risk to Health Care Providers

Consolidation in health insurance markets can injure hospitals and doctors by creating buyer-side market power that can force providers to accept below-market prices, limit patients’ access to care, and reduce innovation in...more

Health Insurance Merger Challenges: Of Antitrust and the Affordable Care Act

The Department of Justice and attorneys general from multiple states last week sued to halt two health insurance mergers, each worth billions of dollars. The challenged deals are Anthem’s planned merger with Cigna and...more

DOJ Challenges Health Insurance Merger

On July 21, 2016, the Department of Justice, Antitrust Division (the “DOJ”) announced that it, along with several state attorneys general, would sue to block two multi-billion dollar health insurance mergers between Aetna and...more

DOJ Seeks to Block Two Major Health Insurance Mergers

The United States Department of Justice (DOJ) is suing to block two proposed mergers between major health insurance companies, claiming that the deals violate antitrust laws and would lead to increased health care costs for...more

New rules on technical provisions Article published in Italian on Insurance Daily on 5 July 2016 N. 960

On June 7, IVASS (Italian Insurance Supervisory Authority) published the long-awaited Regulation no. 24/2016 relating to the investments and assets covering technical provisions....more

When Settlement and Secrecy Do Not Mix

Non-disclosure and confidentiality provisions can be an important aspect of resolving a case through settlement. But when one of the parties is a purported class, and the allegation is an antitrust violation, settlement and...more

California Insurance Commissioner Asks DOJ to Block Proposed Mergers

On June 23, 2016, California Insurance Commissioner Dave Jones submitted a letter urging the Department of Justice, Antitrust Division (DOJ) to block the proposed merger between Aetna, Inc. (Aetna) and Humana, Inc. (Humana). ...more

Florida Court Rejects Auto Body Shops' Effort to Revive their Antitrust Claims Against the Auto Insurance Industry

On May 12, District Judge Gregory Presnell (Middle District of Florida) denied plaintiffs' motion for reconsideration in the In re Auto Body Shop Antitrust Litigation, delivering another victory to insurers seeking to derail...more

CA Insurance Commissioner Urges U.S. Justice Department to Block Merger of Aetna and Humana

The proposed $37 billion merger of health insurance giants Aetna and Humana has faced several regulatory and antitrust hurdles since it was announced in July 2015. Aetna’s proposed acquisition of Humana also coincides with...more

DOJ and North Carolina Challenge Anti-Steering and Tiering Provisions in Managed Care Contracts

The Department of Justice’s antitrust division (the “DOJ”)and the State of North Carolina (“NC”) jointly sued, on June 9, 2016, Carolinas HealthCare System (“CHS”), the largest healthcare system in North Carolina, over...more

Contractual Prohibitions on Health Insurers Steering Policyholders to Lower Cost Providers Draws Antitrust Challenge

The United States Department of Justice has filed an action seeking to enjoin a hospital from enforcing provisions in its contracts with health insurers that prohibit the insurers from steering policyholders to lower cost...more

U.S. Department of Justice Sues North Carolina Hospital System for Insisting on Anti-Steering Provisions in Insurance...

On June 9, 2016, the Antitrust Division of the United States Department of Justice (“DoJ”) filed a complaint against the Charlotte-Mecklenburg Hospital Authority, d/b/a Carolinas Health Care System (“CHS”) in the United...more

Manatt on Health Reform: Weekly Highlights - June 2016#3

CMS targets short-term insurance plans in efforts to stabilize the individual market risk pool; Illinois mandates Medicaid coverage for opioid addiction treatment; and Michigan seeks to restructure State Medicaid financing....more

DOJ and NC File Antitrust Suit Challenging Anti-Steering Restrictions in Payor Contracts

A popular weapon used to contain health care expenditures is the creation by payors and employers of tiered provider networks, which by differentiated co-pays attempt to steer insureds to less expensive choices. In...more

Health Update - May 2016

Actions to Advance Infant and Early Childhood Mental Health - Editor's Note: Children's earliest experiences—both positive and negative—impact their brain formation and in turn their social and emotional, physical,...more

Insurers Gain Additional Dismissals in the Florida Auto Body Action

In early 2014, a group of Florida auto body shops sued the leading auto insurers in their state, alleging that the insurers had conspired to suppress the amounts the auto body shops received in reimbursement rates. The case,...more

Insurer Antitrust Exemption in Europe in Jeopardy

In the United States, the McCarran Ferguson Act provides insurers with an exemption from the federal antitrust laws. Enacted in 1945, the Act provides that conduct that constitutes the "business of insurance" is outside the...more

Insurance Antitrust Newsletter - May 2016

Insurer Antitrust Exemption in Europe in Jeopardy - In the United States, the McCarran Ferguson Act provides insurers with an exemption from the federal antitrust laws. Enacted in 1945, the Act provides that conduct that...more

Insurer Actions Cut the Heart Out of Out-of-Network Providers

Aetna Life Insurance Company recently won a $37 million verdict against a group of Northern California surgical centers, Bay Area Surgical Management, LLC and its affiliates (collectively, Bay Area), for an alleged...more

Aetna vs. BASM: Pigs Get Fat and Hogs Get Slaughtered

On April 13, 2016, a jury in Santa Clara, California awarded Aetna, Inc. $37.4 million from Bay Area Surgical Management, LLC (“BASM”), six of its affiliated surgery centers and its three principals. Aetna had accused the...more

Misuse of market power: How proposed changes to the law will affect the private health insurance sector

The Turnbull Government recently announced that it will adopt the Harper Review's recommendation to amend section 46 of the Competition and Consumer Act. The Government expects to introduce the relevant legislation into...more

European Commission Proposes Non-renewal of the Insurance Block Exemption Regulation

The European Commission has recently issued a Report announcing its preliminary view that the Insurance Block Exemption Regulation (“IBER”) should not be renewed when it expires on March 31, 2017. The IBER provides an...more

Commission set to say goodbye to the insurance block exemption

The insurance industry currently benefits from the Insurance Block Exemption Regulation (Regulation 267/2010) (IBER), which is due to expire on 31 March 2017. IBER exempts from the competition rules, subject to certain...more

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