Insurance Antitrust & Trade Regulation

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Will Increased Consolidation in the Insurance Industry Yield Opportunities or Challenges for Investors?

A recent flurry of activity in the health insurance industry would seem to indicate that investors can expect significant consolidation in the managed care sector....more

Camels and Dogs, Oh My! Defendant Documents Doom Health Provider Trade Association and Insurers’ Motion to Dismiss Antitrust Suit

Over two and one-half years after it was initially filed, an antitrust suit brought by plaintiff ambulatory surgery centers (“ASCs”) against health insurers and a trade association of competing health systems is finally...more

[Event] Evolving the Compliance Function: Leveraging Data to Lead the Convergence of Risk, Internal Audit and Ethics & Compliance...

Things are changing fast in the worlds of governance, risk management and compliance. With each day comes bigger corporate risks and the consequences of not seeing them coming. Companies are beginning to embrace “breaking...more

Investors Should Be Aware of an Interesting Blue Cross Antitrust Case

It was recently reported that Blue Cross and Blue Shield (BCBS), along with the Blue Cross Blue Shield Association, was sued across all states in a class action brought by two types of plaintiffs. One plaintiff class reflects...more

NDRC Issued Opinions and Notice on Drug Price Reform

On May 4, 2015, the National Development and Reform Commission (“NDRC”) and seven agencies including the National Health and Family Planning Commission and the Ministry of Human Resources and Social Security jointly published...more

Insurer Escapes Antitrust Suit, But Hospital Must Continue the Fight

A large regional health insurer extricated itself from an antitrust suit, leaving the dominant local hospital to square off alone versus an ambulatory surgical center (ASC). The U.S. District Court for the Southern District...more

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

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 of plaintiffs’ action, this time directed at plaintiffs’ Second Amended Complaint. The...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

D&O in Brazil and Latin America [Video]

From the 2015 PLUS D&O Symposium session “Emerging International Exposures: What’s Next in Your Neck of the Woods?,” moderator Kevin M. LaCroix, Esq., RPLU (RT ProExec) and panelists Marcus Smithson (Assicurazioni Generali...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

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

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