News & Analysis as of

Health Insurance Antitrust Violations

Pillsbury Winthrop Shaw Pittman LLP

Developments in Association Law 2022 – 2024

The following is a review of notable cases and regulatory developments for nonprofit organizations at the federal and state levels during the last two years....more

Mintz - Antitrust Viewpoints

Reversible Error: District Court Stutters, Ninth Circuit Shudders, Litigation Continues for Sutter

Over ten years ago, individuals and businesses insured by health plans that contract with Sutter Health filed a class action lawsuit against Sutter Health alleging antitrust violations under federal and California laws....more

Epstein Becker & Green

Video: ACA Preventive Coverage Mandate Blocked, Another No-Poach Loss for DOJ, and Employers Prepare for the End of the COVID-19...

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As featured in #WorkforceWednesday: This week, we examine the decision of a Texas district court to strike down an Affordable Care Act (ACA) mandate on preventive medical services and look at the U.S. Department of Justice’s...more

Akerman LLP - Health Law Rx

Healthcare Antitrust – What to Expect in 2021

The year 2020 was an eventful one in the world of healthcare antitrust. The year began with the announcement of the precedent-setting settlement of the California Attorney General’s action against Sutter Health and ended with...more

Health Care Compliance Association (HCCA)

Blue Cross Blue Shield nears settlement for $2.7 billion

Compliance Today (December 2020) - The Blue Cross Blue Shield insurance group has negotiated a possible settlement to sweeping antitrust lawsuits that alleged the group benefited from anticompetitive measures that...more

Akerman LLP - Health Law Rx

“Historic” Settlement of Blue Cross Blue Shield Association Antitrust Action May Significantly Boost Competition in Health...

After over 8 years of hard-fought litigation, the Blue Cross and Blue Shield Association, together with its 36 Blue Cross/Blue Shield members (“the Blues”), recently announced a proposed settlement of class action antitrust...more

Akerman LLP - Health Law Rx

Sutter Health Settles California Attorney General Antitrust Case With Cash and an Agreement to Make Significant Changes to its...

The terms of a settlement that resolved antitrust litigation between the State of California and Sutter Health, the largest health system in Northern California, have now become public, almost two months after the settlement...more

Akerman LLP - Health Law Rx

Antitrust Exemption Allows Health System to Avoid All Claims for Damages in Antitrust Class Action

Atrium Health (formerly known as Carolinas Healthcare System) scored a big victory in its defense of an antitrust class action on March 4, when the Court ruled that the plaintiffs in Benitez v. The Charlotte-Mecklenburg...more

Womble Bond Dickinson

American Hospital Association Rejects Findings of New Health Affairs Hospital Pricing Study

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A new study published in the February 2019 issue of Health Affairs examined growth in hospital and physician services from 2007-14. The study focused on growth in prices for total inpatient care, total outpatient care, and...more

Patrick Malone & Associates P.C. | DC Injury...

Price-fixing scandal ensnares ‘white-hat’ makers of lower-cost generic drugs

To paraphrase what a one-time colleague once wrote about her bosses: Never trust Big Pharma, never trust Big Pharma, never trust Big Pharma. Here’s some of the latest evidence why: Even the industry’s so-called “white hats,”...more

Mintz

DOJ Provides Additional Insight into Its Recent Anti-Steering Settlement

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Last month the Antitrust Division of the Department of Justice (the “DOJ”) announced a proposed settlement in its anti-steering case against Atrium Health (formerly known as Carolinas HealthCare System) (“Atrium”). US v. The...more

Perkins Coie

DOJ Announces Settlement of Anti-Steering Antitrust Case Against Atrium Health

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The U.S. Department of Justice (DOJ) and the Attorney General of North Carolina announced a settlement last week in their civil antitrust case against Atrium Health, the largest hospital system in the state of North Carolina....more

Akerman LLP - Health Law Rx

DOJ Settles “Anti-Steering” Antitrust Case Against Atrium Health

The United States Department of Justice Antitrust Division announced on November 15 that it was settling its antitrust lawsuit against Atrium Health (formerly known as Carolinas Health System)....more

Mintz

Third Circuit Reinstates $67 Million Antitrust “Refusal to Deal” Suit Against Blues

Mintz on

The Third Circuit reinstated an antitrust suit brought by a medical device seller that alleged Blue Cross Blue Shield Association and five of its member insurance plan administrators shut out the seller by conspiring to deny...more

Akerman LLP - Health Law Rx

Per se versus ‘Rule of Reason’ Standard: Judge in Blue Cross Antitrust MDL Proceeding Certifies His Decision For Interlocutory...

In a somewhat unexpected but highly significant move, United States District Judge David Procter (Northern District of Alabama), who is presiding over the In re Blue Cross Blue Shield Antitrust Litigation (Case No....more

Polsinelli

Can a Dominant Health Insurer’s Refusal to Negotiate in Good Faith Be Actionable under the Antitrust Laws? Yes, Says a Federal...

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On April 23, a federal court in Rhode Island fired a warning shot over the bow of dominant health insurers across the country, holding that a refusal to negotiate in good faith with a healthcare provider that focuses...more

Akerman LLP - Health Law Rx

Health Insurers Contend Allergy Test Maker’s Antitrust Claims Make No Economic Sense – Seek Early Dismissal on that Basis

Three health insurers accused of having violated the antitrust laws in Academy of Allergy & Asthma in Primary Care v. Blue Cross Blue Shield of Louisiana, et al. (Eastern District of Louisiana), have filed motions seeking a...more

Akerman LLP - Health Law Rx

Reversal of Fortune: Rhode Island Court Withdraws “Tentative” Decision to Grant Summary Judgment to Health Insurer in Health...

In what was a surprise result, on April 23, Judge William Smith (Chief Judge of the District of Rhode Island) reversed the “tentative” decision he had announced last November, in Stewart Health v. Blue Cross & Blue Shield of...more

Holland & Knight LLP

Healthcare Law Update: February 2018

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Antitrust - FTC Announces Revised Hart-Scott-Rodino Thresholds for Acquisitions and Exclusive Licenses - The Federal Trade Commission (FTC) has announced this year's revisions to the thresholds under the...more

Mintz

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

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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

Hogan Lovells

Court Upholds DOJ Antitrust Lawsuit Challenging Carolinas HealthCare System’s Anti-Steering Provisions

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Despite a recent decision by the Second Circuit suggesting that anti-steering contractual provisions in other industries may not be anticompetitive, DOJ’s lawsuit (United States v. Carolinas HealthCare System) against...more

Mintz

DOJ Anti-Steering Suit Against Carolinas Healthcare Survives Preliminary Motion

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On March 30, 2017, in a closely watched case, a federal district court denied the Motion for Judgment on the Pleadings filed by Carolinas Healthcare against the DOJ Antitrust Division and State of North Carolina’s Complaint...more

Holland & Knight LLP

Healthcare Law Update: March 2017

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Enforcement - OIG Issues Advisory Opinion Allowing Free or Reduced-Cost Lodging and Meals - On March 3, 2017, the U.S. Department of Health and Human Services' (HHS) Office of Inspector General (OIG) issued...more

Patterson Belknap Webb & Tyler LLP

A tale of two mergers: Following their losses in DOJ merger challenges, Anthem fights on and Aetna gives up

In the past month, the DOJ and several state governments scored two trial wins in their challenges to mergers among some of the country’s largest health insurers. First, Judge Bates of the District of Columbia blocked the...more

Polsinelli

DOJ-AmEx Case Could Have Ramifications for Health Care Providers

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The U.S. Department of Justice's loss to American Express sends a message to health care providers: Steering, tiering, exclusive dealing and other contractual arrangements that appear to suppress competition in one part of...more

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