On May 16, 2024, a Federal District Court Judge dismissed a case filed in 2022 by the Oregon Association of Hospitals and Health Systems (OAHHS, the trade group representing hospitals in Oregon) against the State of Oregon and the Oregon Health Authority (OHA).  The suit challenged the law created by Oregon HB 2362, 2021 legislation that required health care entities that meet minimum thresholds to obtain state approval before any mergers or acquisitions.  The new law created the Health Care Market Oversight (HCMO) program, housed within the Oregon Health Authority …

On April 23, 2024, the Federal Trade Commission (FTC) issued a final rule banning many noncompete clauses in employee contracts and several parties quickly filed lawsuits challenging those rules. Only one day after the FTC issued the rule, on April 24, 2024, the Chamber of Commerce of the United States of America, the Business Roundtable, the Texas Association of Business, and the Longview Chamber of Commerce filed suit against the FTC in the United States District Court for the Eastern District of Texas.  On April 23, Ryan, a tax services …

This spring, court cases are dealing with a variety of issues relevant to healthcare marketplace competition issues.  These include a Federal Trade Commission’s (FTC’s) action to block a sale of hospitals in North Carolina, examining the fiduciary duties employer-sponsored health plans have in selecting drug plans, and looking at the acceptability of non-compete clauses in physician contracts. FTC Files suit in North Carolina In February, the FTC authorization of a suit to block Novant Health’s proposed acquisition of two hospitals owned by Community Health Systems (CHS) in North Carolina.  On …

The preponderance of research evidence demonstrates that a lack of meaningful healthcare market competition is bad for consumers – resulting in higher prices, and insurance premiums, without a commensurate increase in quality of care.  New merger guidelines issued in 2023 by the Federal Trade Commission and Department of Justice are just one indication that the Federal government is more closely examining proposed health system mergers.  Increased regulatory scrutiny, among other factors, appears to be causing a slow-down in healthcare merger activity. In addition to merger challenges by state and federal …

On January 25th, 2024, the Federal Trade Commission (FTC) announced that it had authorized a suit to block Novant Health’s proposed acquisition of two hospitals owned by Community Health Systems (CHS) in North Carolina. Nearly a year ago, in February of 2023, Novant Health and Community Health Systems (CHS) signed an Asset Purchase Agreement for Novant to pay $320 million to acquire two North Carolina hospitals from CHS. Novant is currently one of the largest hospital systems in the southeastern United States, and already owns a local hospital that serves …

On January 18, 2024, Victoria Ross, a former University of Pittsburgh Medical Center (UPMC) nurse, filed an antitrust class action suit in the US District Court for the Western District of Pennsylvania against UPMC.  The suit claims UPMC used its “monopsony power to prevent workers from exiting or improving their working conditions, to suppress workers’ wages and benefits, and to drastically increase their workloads, through a draconian system of mobility restrictions and widespread labor law violations that lock employees into sub-competitive pay and working conditions.” Parties to the Suit According …

On December 14, 2023, the North Carolina Attorney General (AG) filed suit against HCA Healthcare, Inc. alleging that HCA violated the Asset Purchase Agreement (APA) it signed when it acquired Mission Health System. HCA is the largest for-profit hospital chain in the United States and in 2018, it acquired Mission Health System, which serves western North Carolina. At the time of the merger, the North Carolina AG required the signing of an APA that included assurances that HCA was committed to continuing certain critical services (including emergency, trauma care, and …

Research indicates that concentrating control of healthcare providers and facilities into a handful of massive health systems leads to higher healthcare costs, without improving quality of care.  There are often limited possibilities available for smaller marketplace participants who are attempting to compete with the giants in the field, especially when the giants engage in unfair business practices. On November 20, 2023, Emanate Health filed an antitrust with the US District Court for the Central District of California.  The complaint alleges that Optum engaged in unfair and unlawful business practices and …

See case page: FTC and California v. John Muir Health and Tenet Healthcare Update: On December 15, 2023, John Muir announced it would terminate its proposed deal to acquire Tenet’s remaining interest in San Ramon Medical Center. On December 18th, the FTC and California moved to dismiss their federal court case and the FTC dismissed its administrative challenge.   Federal antitrust enforcement continues to pick up pace even as we near the year end. On November 17, the Federal Trade Commission sued to block John Muir Health’s proposed $142.5 million …

In recent years, increased scrutiny over the impacts of consolidation in the healthcare industry has driven both antitrust enforcers and policymakers at the federal and state levels to enhance their efforts to address and remedy the source of the issue by improving oversight and review of potential anticompetitive healthcare mergers and acquisitions, both before and after the transaction. As the federal agencies review and revise their merger review guidelines and reporting requirements, several states have also introduced legislation to enhance their review and oversight authority of healthcare transactions in their …