Hospitals

News & Analysis as of

FTC and DOJ Host Workshop Examining Health Care Competition - Updated 2015

The Federal Trade Commission (FTC) and the Antitrust Division of the U.S. Department of Justice (DOJ) held a public workshop on February 24–25, 2015, to examine recent trends and developments in health care provider...more

Hospital-Physician Alignment

Hospital-physician alignment involves the effective coordination between physicians and hospitals in order to accomplish and prioritize patient care and financial goals. Those goals may relate to better patient-centered care,...more

PHIPA offers “no shelter” to Ontario Hospital from class proceedings for breach of privacy

Back in 2012, the Ontario Court of Appeal recognized the tort of invasion of privacy – fast forward to the recent string of privacy breaches of personal information held by health care facilities in Ontario. Along comes...more

Medical Staff By-laws are Contracts? Minnesota Supreme Court Says “Yes”

That sound you just heard was the simultaneous gasp of hospital boards of directors throughout the state of Minnesota. In Medical Staff of Avera Marshall Regional Medical Center v. Avera Marshall, Minnesota’s highest court...more

Alert: Ninth Circuit Recognizes Efficiencies May Enhance Competition in Antitrust Challenge to Merger*

In a rare appellate opinion addressing the merits of a merger challenge, the Ninth Circuit last month sided with the Federal Trade Commission, finding that a 2012 merger of two health care providers in Idaho was likely to...more

Aetna Out of Patience With Hospital’s Alleged Out-of-Network Billing Scheme

Aetna Life Insurance Company (Aetna) is going on the offensive against a Northwest Houston hospital with an out-of-network strategy. On February 23, 2015, Aetna filed suit in Texas federal court against Robert A. Behar, M.D....more

Florida Hospitals Face Glenn Close-Like Threat

Remember the evil Glenn Close character in Fatal Attraction? We were sure Michael Douglas had drowned her in the bathtub, but she popped up again, still alive and scary as all get-out. Class actions by uninsured...more

Health Care Competition Follow-up Exam: Highlights from the Second FTC/DOJ “Examining Health Care Competition” Workshop

Last week, the Federal Trade Commission (FTC) and the Department of Justice (DOJ) co-hosted the second installment of their public workshop series, “Examining Health Care Competition.” Complementing last year’s focus on...more

Ninth Circuit Court of Appeals Nixes Hospital System Acquisition of Physician Practice Group: Preserving Competition Trumps Better...

On February 10, 2015, the United States Court of Appeals for the Ninth Circuit (which covers Idaho, Montana, Oregon, Washington, California, Nevada, Alaska, Hawaii and Arizona) ordered St. Luke’s Health System, Ltd. (“St....more

Ninth Circuit Affirms Divestiture of Consummated Physician Practice Acquisition

The U.S. Court of Appeals for the Ninth Circuit affirmed an Idaho federal district court’s decision ordering the divestiture of a physician practice group that had been acquired by a competing health system. The case, which...more

Olympus Sued Over “Superbug” Infections

The New York Times recently reported that 179 patients at the UCLA Ronald Reagan Medical Center were exposed to a potentially deadly “superbug” between October of 2014 and January of 2015. As of February 18, the infection of...more

Anatomy of a Provider Merger Antitrust Challenge (Part 2)

This is the second in a six-part series discussing the Federal Trade Commission’s challenges to provider mergers. Following the initial Introduction and Background (Part 1), the series discusses The Need for Early Legal...more

Peer Review Concludes with Termination of Reviewer

You read that correctly: the hospital fired the physician who did the reviewing in a medical staff peer review proceeding. Hospital executives present at the proceeding felt the reviewing physician was too harsh in...more

Tennessee Supreme Court Holds That Healthcare Providers Can Only collect What Insurance Companies are willing to Pay

A woman is seriously injured in a car accident. It is not her fault. She is taken to the emergency room where she is treated. When she is released, the hospital bills total $100,000. The woman has health insurance. The...more

Medicare RAC Program Improvements Delayed Until 2016 - Shorts on Long Term Care February 2015

The Centers for Medicare and Medicaid Services (CMS) had planned to award new contracts to companies that act as Medicare’s recovery audit contractors (now referred to as recovery auditors) (RAs) for operation of the Medicare...more

FTC Notches Yet Another Victory in a Provider Merger Case

On February 10, in Saint Alphonsus Medical Center-Nampa v. St. Luke’s Health System (St. Alphonsus), the U.S. Court of Appeals for the Ninth Circuit handed the Federal Trade Commission yet another provider-merger win. ...more

Ninth Circuit and Massachusetts Superior Court Release Important Antitrust Decisions

The Ninth Circuit Court of Appeals and a Massachusetts Superior Court each recently released decisions dealing with alleged violations of antitrust prohibitions that implicate a number of important issues surrounding health...more

In it Together -- Emerging Joint Venture Structures for Hospitals and Insurers

Locke Lord lawyers Jon Biasetti, Baird Allis and Benjamin Sykes provide a detailed look at recent efforts by hospitals, physician practice groups and health insurance and managed care companies to lower health care delivery...more

Ways and Means Committee to Markup Medicare Fraud, Competitive Bidding, and other Medicare Policy Bills

On February 26, 2015, the House Ways and Means Committee is scheduled to vote on the following bills: H.R. 1021, “Protecting the Integrity of Medicare Act of 2015” – a sweeping bill to promote Medicare program...more

Federal Court Decision Demonstrates Ongoing Challenges Faced by Plaintiffs in Data Breach Litigation

On February 11, 2015, the U.S. District Court for the Southern District of Texas dismissed a class action complaint against the St. Joseph Health System arising out of a data security breach that occurred after hackers...more

These Doctors Work Hard – Over 24 Hours a Day

Sir Arthur Conan Doyle might have called it “The Case of the Doctors Who Work More than 24 Hours a Day.” Unfortunately for the physician group in question, Sir Arthur wasn’t the author; the federal court for the Northern...more

Hospital Engagement Network Contract Solicitation

CMS is requesting proposals for Hospital Engagement Network (HEN) contracts from qualified entities to work on reducing preventable hospital acquired conditions and readmissions through the Partnership for Patients...more

Health Update - February 2015

Cyber Risk Insurance Policies: What You Need to Know - Editor’s Note: As data breach incidents and related cyber risks continue to increase and gain publicity—and government agencies become more actively involved in...more

Health Care Update - February 2015 #3

In This Issue: - IRS in the ACA Spotlight - DOJ and FTC Examine Competition - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Congressional Initiatives - Other...more

Texas Supreme Court Argument Preview - 2/15 #2

The Texas Supreme Court will hear argument in two mandamus petitions on Wednesday, February 25, 2015, beginning at 9:00 am. ...more

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