Insurance Antitrust Legal News - March 2013 • Volume 2, Number 2

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In This Issue:

- MULTIPLE BILLS INTRODUCED IN CONGRESS TO REPEAL HEALTH INSURERS’ ANTITRUST EXEMPTION:

Over the course of the last two months, four separate bills have been introduced in the House of Representatives (H.R. 99, H.R. 344, H.R. 743 and H.R. 911) that would modify the McCarran Ferguson Act (15 USC 1011 et seq.) to eliminate the limited antitrust exemption currently provided in the Act as it relates to health insurers. Three of the bills, H.R. 99, H.R. 743 and H.R. 911, were introduced by long-time proponents of McCarran repeal -- Representative John Conyers (D-Michigan), Representative Peter DeFazio (D-Oregon) and Representative Paul Gosar (R- Arizona) – while the fourth bill, H.R. 344, was introduced by a relative “newcomer” to the issue, Representative Steven Lynch (D-Massachusetts)....

- ILLINOIS HOSPITAL BRINGS ANTITRUST SUIT AGAINST RIVAL HOSPITAL ALLEGING IT PRESSURED INSURERS NOT TO CONTRACT WITH PLAINTIFF:

On February 5, Methodist Medical Center, in Peoria, Illinois, announced that it had filed an antitrust lawsuit in the United States District Court for the Central District of Illinois against OSF Saint Francis Hospital, Peoria’s largest hospital, accusing Saint Francis of impeding Methodist’s ability to compete with it for hospital patient admissions. Methodist contends that Saint Francis is the only area hospital that provides certain essential services, such as tertiary pediatric services, solid organ transplants, and NICU treatment of low birth rate babies, and that Saint Francis has sought to leverage that circumstance to pressure health insurers not to permit Methodist into their preferred provider networks....

- AETNA ANNOUNCES SALE OF ITS MISSOURI MEDICAID BUSINESS TO WELLCARE IN CONNECTION WITH ITS EFFORTS TO GAIN REGULATORY APPROVAL FOR ITS ACQUISITION OF COVENTRY HEALTH:

On January 22, Aetna announced plans to sell its Missouri Medicaid business, Missouri Care, to WellCare Health Plans, a nationwide managed care services provider that focuses on Medicare and Medicaid business. As Aetna explained in a press release announcing the deal, the sale is related to Aetna’s proposed acquisition of Coventry Health Care, a $5.7 billion deal announced last August, and is being undertaken to eliminate an overlap in the Medicaid businesses both Aetna and Coventry currently have in Missouri. While Aetna is divesting its interest in Missouri Care, Aetna intends to continue to provide Medicaid business in Missouri through HealthCare USA, Coventry’s Medicaid entity in the state, after the Coventry deal is completed...

- SOUTH CAROLINA INSURANCE COMMISSIONER APPROVES WELLCARE’S ACQUISITION OF UNITEDHEALTH OF SOUTH CAROLINA’S MEDICAID BUSINESS:

On January 4, South Carolina Interim Director of Insurance Raymond G. Farmer approved WellCare Health Plans proposed acquisition of UnitedHealthcare of South Carolina’s Medicaid business...

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