THE SOURCE BLOG

See UFCW & Employers Benefit Trust v. Sutter Health case page.   Last fall, we updated you on a key California case brought by self-funded payers against Sutter Health, the dominant health care provider in Northern California, styled UFCW &amp|Employers Benefit Trust v. Sutter Health. At that time, the litigation had been hamstrung by Sutter’s attempts to take the dispute to arbitration, which ultimately were unsuccessful, landing the parties back in state court in San Francisco County. Two years after the plaintiffs filed their complaint in April 2014, the court denied Sutter’s …

See UFCW & Employers Benefit Trust v. Sutter Health case page.   The Source has been following UFCW &amp|Employers Benefit Trust v. Sutter Health, since the complaint it was filed in state court in San Francisco in April 7, 2014. A grocery store union is the named plaintiff in the putative class action whose class includes all self-funded payers in California who compensated Sutter for acute care services while the company was engaging in anticompetitive practices alleged to violate California’s antitrust law, the Cartwright Act, and other state statutes relating to unfair …

There seems to be a fair amount of disagreement in Washington lately over the federal merger review process. On the one hand, the American Antitrust Institute is calling for increased merger enforcement from the next presidential administration, and on the other, the House just passed H.R. 2745, a bill that limits the Federal Trade Commission’s enforcement authority. The bill, which is opposed by Democrats and the White House, passed in the House 235-171, largely along party lines. House Republicans claim the bill addresses their concerns that a proposed merger is …

On March 1, the Supreme Court decided Gobeille v. Liberty Mutual Insurance Co., holding that ERISA preempted a Vermont law’s APCD reporting requirements for self-funded employee health plans (see our case brief here). This case has enormous implications for price transparency and cost containment strategies, especially at the state level. To lay out the issues and offer predictions as to Gobeille’s consequences, Health Affairs Blog ran a four-part series on the case, including one by Source Executive Editor and favorite collaborator Erin C. Fuse Brown called The Consequences Of Gobeille v. Liberty Mutual For Health Care …

The FTC today expressed concerns about proposed legislation in West Virginia aimed at facilitating provider mergers in official written comments to the measure. The state’s legislation was drafted after the FTC challenged a West Virginia hospital merger in November, which we blogged about here. The FTC’s concerns are laid out in its press release, included below. In short, the FTC says it isn’t trying to prevent the good healthcare mergers, just the bad ones. March, 10, 2016 FTC Press Release: Federal Trade Commission staff submitted written comments on the competitive impact …

Last month, in a letter to the U.S. Department of Justice (DOJ) Antitrust Division, the American Antitrust Institute described the competitive and consumer concerns surrounding the proposed health insurance mergers of Aetna-Humana and Anthem-Cigna. Source Advisory Board Member and AAI Advisor Tim Greaney co-authored the letter with AAI President Diana Moss. Professor Greaney testified before a House subcommittee last September on the dangers posed by the mergers, and submitted this prepared statement (as did Source Executive Editor Jaime King, who submitted this prepared statement). AAI’s letter argues, based on economic evidence, …

The FTC closed out 2015 with a number of actions aimed at anticompetitive provider combinations. Hospital mergers were the primary focus, with three hospital merger challenges filed in the last two months of 2015, but they were not the only providers subject to challenge, as the FTC also settled over an allegedly anticompetitive merger with two specialty physicians practices in late December. The challenged hospital mergers involved providers in the Huntington, West Virginia, Chicago, Illinois, and Harrisburg, Pennsylvania areas. Pennsylvania was also where the FTC challenged the merger of orthopedics practices. …

UPDATE: On November 6, we blogged about Judge Darrow’s ruling that antitrust defendant OSF Healthcare System could not file its entire summary judgment motion, along with exhibits, under seal. In fact, it is not just OSF that wants confidentiality in the case. Plaintiff Methodist Health Services Corporation has also supported the imposition of a protective order, and the designation of documents as confidential. In the latest on the back-and-forth over how much of the summary judgment motion and opposition briefs will are to be filed under seal, plaintiff Methodist filed, …

Source Executive Editor Jaime King co-authored a new report with researchers at the Nicholas C. Petris Center on Health Care Markets and Consumer Welfare, School of Public Health, University of California, Berkeley, titled State Actions to Promote and Restrain Commercial Accountable Care Organizations. The reports abstract reads: Accountable Care Organizations (ACOs), originally developed as part of the Affordable Care Act (ACA), have grown in both the public and private sectors. Commercial ACOs have the potential to improve healthcare quality and patient outcomes while achieving cost savings. However, they may also present …

The BC/BS multi-district litigation over alleged market allocation and other antitrust violations by the insurer and their Association caught our eye again this week when Defendant Blue Cross Blue Shield of Michigan filed a motion to preclude certain discovery. The discovery requests BCBSM objects to relate to Aetna’s lawsuit against BCBSM that settled in May after five years in federal court in Michigan. As you recall, Aetna’s antitrust suit against Blue Shield of Michigan that began with this 2011 complaint had been set to go to trail on May 26, 2015, but …