On Thursday, February 5, a federal jury ordered Medtronic to pay $381.7 million to Applied Medical for antitrust violations, finding that Medtronic used its market power to illegally stifle competition through bundling and exclusive-dealing contract terms. Parties to the Case Both Medtronic and Applied Medical produce a surgical instrument called an advanced bipolar device (ABD), which uses electrical current to cut tissue and seal blood vessels during surgery.  Medtronic is the largest medical device supplier in the world.  Medtronic has a dominant market share in the ABD market while Applied […]

Discussions of health care consolidation often center on providers and insurers, but growing concentration among the companies that operate behind the scenes poses equally serious risks.  For example, the Change Healthcare data breach in early 2024 caused significant disruptions in healthcare because Change processes approximately half of all U.S. medical claims, and a single cyberattack disrupted large swaths of the health care system.  Similar dynamics are playing out in other sectors of the health care system.  More than 305 million patients have electronic health records controlled by Epic.  At the […]

On November 9, the Indiana Department of Health issued a Certificate of Public Advantage (COPA) to allow Union Hospital to acquire Terre Haute Regional Hospital. The proposed merger would effectively combine the two only acute care hospitals in Vigo County and create a near‐monopoly for inpatient hospital services in the Terre Haute, Indiana area. The proposed acquisition drew opposition from the Federal Trade Commission (FTC) (under both the Biden and Trump administrations) and the state’s own Attorney General (AG). The COPA prevents state enforcement to challenge the merger as an […]

This post is part of our ongoing coverage of the CHA v. OHCA lawsuit. See case page here. In this post, we examine the claims made by the California Hospital Association (CHA) in its recent lawsuit filed against the California Office of Health Care Affordability (OHCA) regarding OHCA’s plan to implement spending targets for hospitals (Case #  CPF25519370).  While many stakeholders, including CHA, the California Medical Association (CMA), and others, have expressed concerns about the spending targets announced by OHCA and the methodology used to establish them, dissatisfaction with an administrative […]

August and September 2025 were active months in the U.S. Chamber of Commerce’s case challenging the Federal Trade Commission (FTC)’s new rules under the Hart-Scott-Rodino (HSR) Act.  The FTC finalized changes to the HSR pre-merger notification rules in October 2024, and the Chamber filed suit in January 2025. In August and September, the Chamber moved for summary judgment, the FTC filed a brief in opposition, and most recently, the Chamber filed a brief in support of its summary judgment motion. History of the Hart-Scott-Rodino Act Congress passed the original Hart-Scott-Rodino […]

On August 13, 2025, President Donald Trump issued an executive order revoking Executive Order 14036 (Promoting Competition in the American Economy) issued by President Joe Biden on July 9, 2021.  Biden’s executive order was remarkably lengthy and detailed, addressing many areas with significant implications for healthcare markets and competition.  Revoking the order represents a new direction in the Federal Government’s competition priorities. Biden’s Order on Promoting Competition Biden’s 2021 order was unusual in its scope and size, signaling an intention to reinvigorate antitrust enforcement across U.S. industries. The order noted […]

Steering methods, where health plans are able to incentivize patients to choose high-value, cost-effective care can be critical to the financial health of these plans.  New York–Presbyterian Hospital is facing mounting legal and regulatory challenges over allegations that it sought to limit competition and prevent insurers from steering patients to lower-cost options.  On July 25, 2025, the Cement and Concrete Workers DC Benefit Fund, a self-funded union health plan, filed suit against The New York and Presbyterian Hospital, claiming that New York Presbyterian (NYP) engaged in various anti-steering efforts in […]

Update: On Monday, July 28, 2025, U.S. District Court Judge Brian Miller issued a preliminary injunction blocking the law (which would have taken effect on January 1, 2026) until the federal court issues final judgement. In April 2025, Arkansas passed legislation prohibiting pharmacy benefit managers (PBMs) from acquiring or holding a direct or indirect interest in pharmacies.  This law makes Arkansas the first state to enact a structural approach to address concerns about PBM business practices.  To date, three separate lawsuits have been filed challenging the law.  This article looks […]

On July 3, 2025, a three-judge panel of the 9th U.S. Circuit Court of Appeals upheld an Oregon state law that allows the state to review, approve or deny proposed health care mergers, affirming a lower court ruling from May of last year. History of the Case The Oregon Association of Hospitals and Health Systems (OAHHS – a trade association representing Oregon hospitals and health systems) originally filed suit in Federal District Court October 2022 challenging the constitutionality of an Oregon law enacted in 2021, that required health care entities […]

On May 21, 2025, a three-judge panel of the Sixth Circuit Court of Appeals in Ohio reversed a lower court’s decision to dismiss a case filed by Tiara Yachts against Blue Cross Blue Shield of Michigan (BCBSM).  The rulings hinged on whether BCBSM acted as an Employee Retirement Income Security Act (ERISA) fiduciary when administering Tiara Yachts’ self-funded insurance plan.  The lower Court had ruled that BCBSM’s actions did not qualify as fiduciary conduct under ERISA, claiming that the case was a contractual dispute as the complaint was covered by […]