On February 19, 2013, the U.S. Supreme Court unanimously ruled that a local hospital authority’s acquisition of a hospital in Georgia was not immunized from the antitrust laws under the state action doctrine. In doing so, the Supreme Court overturned decisions by a federal district court and the Eleventh Circuit that would have allowed the transaction to proceed, despite allegations that the merger would have substantially lessened competition. The case, FTC v. Phoebe Putney Health System, Inc., has direct ramifications for the estimated 20 percent of hospitals in the United States that are owned by states and local governments, as well as for all industries in which states and local governments are involved.