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Insurance General Business Antitrust & Trade Regulation

Read Insurance Law updates, alerts, news, and legal analysis from leading lawyers and law firms:

Eleventh Circuit Reinstates Auto Body Shops’ Antitrust Claims Against Insurers

In a 2-1 decision issued on September 7, 2017, the Eleventh Circuit reversed a district court decision dismissing antirust claims brought by auto body shops against a group of car insurance companies in the In re Auto Body...more

Seventh Circuit Affirms Grant of Summary Judgment in Hospital Antitrust Case

by King & Spalding on

On June 9, 2017, the United States Court of Appeals for the Seventh Circuit affirmed the lower court’s grant of summary judgment in Methodist Health Services Corp. v. OSF Healthcare System d/b/a Saint Francis Medical Center,...more

Antitrust Challenge to Narrow Network Products – 7th Circuit Rules in Favor of Exclusive Agreement

by Ruder Ware on

The health care market has recently seen a resurgence in narrow network products. To a significant degree, the resurgence of these products has been driven by the need for managed care plans looking for new avenues to help...more

There May Be Coverage for the Defense and Settlement of FTC Claims

A number of companies have been sued by the FTC in recent years, alleging, for example, that the company made claims regarding the product or service without adequate substantiation. Many of these companies are small private...more

Seventh Circuit OKs Exclusive Network Agreements Between “Must-Have” Hospital and Health Insurers

by Mintz Levin on

In an opinion written by Judge Posner, the Seventh Circuit on Friday gave its stamp of approval to a “must-have” hospital’s bargaining to exclude competitors from certain narrow-network payor contracts in and around Peoria,...more

Can Purchasing Efficiencies Save Mega-Mergers? The D.C. Circuit Says “No”

by Proskauer Rose LLP on

Efficiencies, economies of scale, and the general desire to improve the customer experience are the lifeblood of all mergers. And one of the most common efficiencies in any deal comes from enhanced purchasing power, or the...more

Bill to Eliminate Health Insurers' Antitrust Exemption Passes in the House

by Baker Ober Health Law on

On March 22, the House of Representatives passed H.R. 372, the "Competitive Health Insurance Reform Act of 2017," by a vote of 416-7. The legislation would repeal the antitrust exemption that the health insurance industry...more

Antitrust & Distribution Alert - The End of the Insurance Block Exemption Regulation

On 31 March 2017, the EU Insurance Block Exemption Regulation n° 267/2010 (“IBER”) will expire and will not be renewed. Therefore, the types of cooperation it covered will fall under the general rules of competition...more

DAMITT Q3 2016 Update: No Let Up in Antitrust Merger Investigation Activity or the Duration of Merger Investigations; Antitrust...

by Dechert LLP on

Fast Facts - - In the first three quarters of 2016, there were 24 significant merger investigations, which is on pace to challenge the record of 37 set in CY2015. - Significant merger investigations through Q3 2016...more

Big Summary Judgment Win for Hospital Defending $300M Exclusive Dealing Antitrust Suit

by Mintz Levin on

After fending off a motion for judgment on the pleadings in March 2015, a small hospital in Peoria, Illinois lost on summary judgment in its $300 million antitrust suit alleging illegal exclusive dealing and attempted...more

Compounding Pharmacy’s Group Boycott Claim Survives Motion to Dismiss

On August 23, 2016, the District Court for the Eastern District of Missouri allowed claims by a compounding pharmacy to proceed, denying a motion to dismiss filed by the defendant pharmacy benefit manager (“PBM”). In...more

DOJ Challenges Health Insurance Merger

by King & Spalding on

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

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

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

by Foley & Lardner LLP on

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

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

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

by Mintz Levin on

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

Insurers Gain Additional Dismissals in the Florida Auto Body Action

by Baker Donelson on

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

by Baker Donelson on

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

by Baker Donelson on

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

by BakerHostetler on

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

by Buchalter on

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

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

by Locke Lord LLP on

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

UnitedHealth Settles NY Attorney General Antitrust Probe

by Baker Donelson on

In early January, the New York Attorney General's Office announced that it had reached an agreement with UnitedHealth that would conclude the AG Office's investigation into UnitedHealth's marketing of elder care and nursing...more

Proposed Aetna-Humana Merger Passes Another Hurdle in Antitrust Review

by Snell & Wilmer on

The proposed merger between major health insurers Aetna Inc. and Humana Inc. continues to inch closer to finalization. In a recent press release, Aetna announced that 10 states have now signed off on its proposed acquisition...more

OIG Issues (Another) Favorable Advisory Opinion Regarding Medigap/Preferred Hospital Network Arrangement in Advisory Opinion 16-01

by Baker Ober Health Law on

On January 7, 2016, the Department of Health and Human Services, Office of Inspector General (OIG) issued Advisory Opinion 16-01, approving yet another insurer’s proposed contract with a preferred hospital network. The...more

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