On May 9, 2024, the DOJ announced the formation of a new task force on health care monopolies and collusion (the HCMC Task Force) that will “guide the division’s enforcement strategy and policy approach in health care, including by facilitating policy advocacy, investigations and, where warranted, civil and criminal enforcement in health care markets.”

Background

The Biden administration has placed focus on a various efforts to enhance antitrust enforcement in the health care industry.

For example, the White House released a statement in December 2023 declaring their plan to promote competition in health care and support lowering prescription drug costs. This is a multifaceted plan that includes, but is not limited to:

• promoting equitable access to lower-priced taxpayer-funded drugs;
• launching a cross-government public inquiry into corporate greed in health care;
• identifying anticompetitive “roll ups” that currently evade antitrust review;
• increasing ownership transparency;
• increasing Medicare Advantage transparency;
• stopping alleged large pharmaceutical company tactics that raise prices for working families;
• cracking down on anticompetitive and anti-consumer practices in Medicare Advantage;
• addressing anticompetitive misuse of the patent system;
• banning non-compete agreements that trap health care workers and others;
• developing new payment models for doctors including supporting independent doctors; and
• improving transparency of hospital charges.

The FTC also has inquiries underway regarding the operations of pharmacy benefit managers, or “prescription drug middlemen,” over criticisms about drug access, a study on the impact of physician consolidation, including physician practice mergers and hospital acquisitions of physician practices, and a study on the effects of certificates of public advantage on prices, quality, access, and innovation of healthcare services.

Last month, the DOJ, in a joint project with the FTC, launched an online portal to allow for anyone to submit a healthcare competition complaint.

HCMC

The HCMC Task Force’s objective is to identify monopolies and collusive practices contributing to rising health care costs, decreased quality of care, and the creation of single points of failure in the industry. Assistant Attorney General of the DOJ’s Antitrust Division, Jonathan Kanter, stated, “[e]very year, Americans spend trillions of dollars on health care, money that is increasingly being gobbled up by a small number of payers, providers and dominant intermediaries that have consolidated their way to power in communities across the country.” With a focus on policy advocacy, investigation, and enforcement, the HCMC Task Force will promote competition and innovation that will benefit patients, healthcare professionals, businesses and entrepreneurs alike. Kanter shared, in an interview, that “the purpose of this task force is to ensure that we are taking a whole-of-division approach as well as a whole-of-government approach to ensure that we hold monopolies and bad actors accountable for violations of the antitrust laws in the healthcare space.”

The HCMC Task Force will seek to address competition concerns in the health care industry over issues including:

• payer-provider consolidation;
• serial acquisitions;
• labor and quality of care;
• medical billing;
• health care IT services; and
• access to and misuse of health care data.

The HCMC Task Force will be led by Katrina Rouse, an antitrust prosecutor who has been with the DOJ’s Antitrust Division since 2011. Rouse will service concurrently as the Deputy Director of Civil Enforcement and Special Counsel for Health Care. Others joining the HCMC Task Force will include civil and criminal prosecutors, economists, health care industry experts, technologists, data scientists, investigators, and policy advisors.

Key Takeaway

The formation of the HCMC Task Force is a continuation of Biden administration efforts to investigate and crack down on monopolies and collusion in the health care industry. The ultimate goals for the HCMC Task Force are to promote and enhance health care quality, affordability, and accessibility.