One of the more fascinating developments in group health plan law has been the growth of antitrust claims by group health plans against drug manufactures who allegedly agree to delay the production of generic drugs once a patent has expired. A federal judge in California just cut back a lawsuit filed by UnitedHealth against drug manufactures Teva and Gilead, who allegedly conspired to keep a generic version of an HIV treatment off the market. The immediate fight (on a motion to dismiss) was largely about procedural issues—whether United could sue under certain state consumer protection statutes when it was not a consumer of the drugs in question, but rather an insurer/TPA. The Court held that at least for some states, United could sue, or otherwise the purpose of the statues would be greatly diminished. For other states, however, the Court relied upon precedent that suggested a more narrow interpretation of those particular consumer protection laws.

Group health plans lose billions to overpayment, fraud, and various violations of the law every year. There are practical things that plan sponsors can do if they are interested is understanding how to recover those sums.