News & Analysis as of

Health Insurance Department of Justice (DOJ) Insurance Industry

Goodwin

Reliance on Third-Party “Pricing” Facilitators Under Increasing Antitrust Scrutiny

Goodwin on

In the past year, healthcare systems and providers across the country have filed a series of antitrust lawsuits against MultiPlan Inc. and major US health insurers, alleging a hub-and-spoke conspiracy to fix and reduce...more

Faegre Drinker Biddle & Reath LLP

Members of Congress Continue to Press DOJ on Health and Dental Insurance Antitrust Enforcement

Congressional leaders continue to seek information from the U.S. Department of Justice (DOJ) concerning the DOJ’s efforts to enforce the Competitive Health Insurance Reform Act (CHIRA), which partially repealed the...more

Faegre Drinker Biddle & Reath LLP

New Amendment to McCarran-Ferguson Act Repeals Important Antitrust Exemption for Health and Dental Insurance Companies

Just before leaving office, former President Trump signed the Competitive Health Insurance Reform Act (CHIRA) on January 13, 2021. Among other things, CHIRA amends the McCarran-Ferguson Act to repeal the federal antitrust...more

Jones Day

New Law Eliminates 75-Year-Old Antitrust Exemption for "Business of Health Insurance"

Jones Day on

The Development: Congress unanimously passed and before leaving office, President Trump signed into law, the Competitive Health Insurance Reform Act ("CHIRA"). CHIRA limits application of the McCarran-Ferguson Act, an...more

King & Spalding

Congress Restores Application of Federal Antitrust Laws to Health Insurers

King & Spalding on

On December 23, 2020, the U.S. Senate unanimously passed the Competitive Health Insurance Reform Act of 2020, which includes a provision that would repeal the limited federal antitrust immunity currently granted to certain...more

Schwabe, Williamson & Wyatt PC

Texas Federal District Court Opines That the Affordable Care Act Is Invalid in Its Entirety: Where Does It Go from Here?

On December 14, 2018, a federal judge in Texas, in response to a lawsuit brought by 20 Republican states, issued a judgment opining that the Affordable Care Act (“ACA”) is invalid in its entirety. That is a very sweeping...more

Akerman LLP - Health Law Rx

DOJ Antitrust Division Grants Approval to Proposed Cigna/Express Scripts Merger

On September 17, the United States Department of Justice (DOJ) Antitrust Division issued a “closing statement” in which it announced that it was closing its investigation into Cigna’s proposed acquisition of Express Scripts,...more

Epstein Becker & Green

Health Care Industry Vertical Transactions: Expect Intensified Antitrust Reviews Despite Recent Government Setback

While federal officials have stated their intent to persist in questioning vertical relationships that they hypothesize cause downstream economic effects on product flow and prices, a recent loss by the Department of Justice...more

Pierce Atwood LLP

Aetna-Humana Merger Blocked

Pierce Atwood LLP on

The District of Columbia federal court recently ruled that a proposed $37 billion merger between health insurance giants Aetna and Humana cannot proceed, granting the US Department of Justice’s bid to block the combination on...more

Baker Donelson

Anthem and Aetna Merger Trials Begin

Baker Donelson on

While the election of Donald Trump as the nation's next president is clearly the biggest news in Washington over the last two months, for the insurance industry, big news has also been made at the federal district courthouse....more

K&L Gates LLP

Judge Rejects Joint Defense Privilege Claim; Orders Would-be Merger Partners to Produce Sensitive Emails to DOJ

K&L Gates LLP on

On October 14, 2016, a federal judge in Washington, D.C., ruled that two companies could not claim a joint defense privilege for certain sensitive emails they had exchanged in connection with their proposed merger. ...more

Baker Donelson

Anthem and Aetna Prepare for Merger Trials Against the DOJ Antitrust Division

Baker Donelson on

In late July, the DOJ Antitrust Division filed actions in federal district court seeking to derail both the Anthem/Cigna and Aetna/Humana mergers. In each case, the DOJ contended that consumers would face higher insurance...more

Baker Donelson

DOJ and States Challenge Health Insurer Mergers

Baker Donelson on

Following more than a year of regulatory review, in late July 2016 the Department of Justice (DOJ) Antitrust Division and a number of states filed actions seeking to derail both the Anthem/Cigna and Aetna/Humana mergers. In...more

Williams Mullen

DOJ Sues to Enjoin Two Large Health Insurer Mergers

Williams Mullen on

In July 2015, health insurer mergers were announced between Anthem and Cigna and between Aetna and Humana. The effect of these mergers would elevate Anthem/Cigna to the #1 rank in size among national health insurers. ...more

Polsinelli

Mega-Mergers Highlight Risk to Health Care Providers

Polsinelli on

Consolidation in health insurance markets can injure hospitals and doctors by creating buyer-side market power that can force providers to accept below-market prices, limit patients’ access to care, and reduce innovation in...more

Locke Lord LLP

Contractual Prohibitions on Health Insurers Steering Policyholders to Lower Cost Providers Draws Antitrust Challenge

Locke Lord LLP on

The United States Department of Justice has filed an action seeking to enjoin a hospital from enforcing provisions in its contracts with health insurers that prohibit the insurers from steering policyholders to lower cost...more

The Volkov Law Group

Justice Department Charges Pharma President with Kickback Conspiracy

The Volkov Law Group on

In the public relations battle following the issuance of the Yates Memo, the Justice Department can now cite one example for the new policy – the recent arrest and charging of Carl Reichel, former President of Warner...more

Baker Donelson

Congress Takes Long Look at Proposed Health Insurance Mergers

Baker Donelson on

While the Department of Justice Antitrust Division is responsible for reviewing the proposed Anthem/Cigna and Aetna/Humana mergers for any potential competitive concerns, Congress jumped into the process with both feet in...more

BakerHostetler

Send Lawyers, Guns and Money:* Providers Lining Up Against Anthem/Cigna and Aetna/Humana Mergers

BakerHostetler on

In the wake of Anthem’s proposed acquisition of Cigna and Aetna’s proposed acquisition of Humana, providers are lining up to be heard. Take the American Medical Association (AMA), for example, which is urging federal and...more

Baker Donelson

Health Insurers Announce Merger Plans; Congress Announces Intention to Review

Baker Donelson on

In the last few months, several of the largest commercial health insurers in the nation have announced their intentions to merge. First, Aetna (currently the nation’s third largest health insurer by revenue) announced its...more

BakerHostetler

Do Not Pass Go, Do Not Collect $200: Michigan Statute and Regulatory Order Banning MFN Provisions in Provider Contracts Ends...

BakerHostetler on

In the wake of the passage of a Michigan statute and regulatory order banning the use of most favored nation (“MFN”) clauses by insurers, health maintenance organizations, and nonprofit health care corporations in contracts...more

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