The most recent episode of The Week in Health Law podcast features The Source’s own Professor Jaime King! The episode, titled “Competition, Coordination, and Complexity,” covers price transparency issues, provider competition and consolidation, and ERISA preemption. In the discussion, Professor King explains how greater price transparency will help promote competition in some ways, but it will not solve all problems. The first model of price transparency directed at consumer rates only influences consumers who purchase “shop-able services” (services that patients assume are substitutable for one another, such as lab tests). Professor …

A recently published Public Agenda report by David Schleifer, Rebecca Silliman, and Chloe Rinehart provides a wealth of new information about how Americans are seeking out and using information about health care prices. One key finding from the report is that while Americans do seek out information about how much their health care will cost, they still need more help accessing price information, in particular provider price comparisons. The report analyzes information found through a national survey and state surveys of residents in Florida, New York, New Hampshire, and Texas. …

September 2016 Update: We previously blogged about the suit filed in June by the Department of Justice and the North Carolina Attorney General against Carolinas Healthcare System (“CHS”). The case involves a Sherman Act Section 1 challenge to anti-steering provisions in CHS’ contracts with insurers. In August, CHS moved for judgment on the pleadings. CHS filed its reply brief in support of the motion on Wednesday. In its brief, CHS argues that the DOJ complaint is insufficient as a matter of law because it fails to show that the anti-steering …

July 2016 Update: In April, the U.S. Court of Appeals for the 11th Circuit overturned the district court’s February 2015 decision dismissing the class-wide allegations in this case. The case charges certain Florida medical centers and Nashville, Tenn.-based HCA with billing exorbitant and unreasonable fees for emergency radiological services covered in part by Florida Personal Injury Protection (“PIP”) insurance. Under Florida’s No Fault Car Insurance Law, drivers are required to have $10,000 in PIP insurance, and the complaint alleges that patients covered by PIP who received radiological services at emergency rooms following …

At long last, a three-judge panel has ruled in favor of the plaintiffs/appellants in their Ninth Circuit appeal of the dismissal of the putative class action Sidibe v. Sutter Health, filed in federal district court in San Francisco in September 2012 and dismissed in June 2014. The Ninth Circuit heard arguments on July 8, and issued this unpublished opinion a week later. The district court dismissed the third amended complaint on the grounds that the plaintiffs’ geographic market definition, one of the bases for claims brought under the Sherman Antitrust …

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 …

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 …

Today, the Supreme Court decided Gobeille v. Liberty Mutual Insurance Co. in favor of Respondent, Liberty Mutual. The Court held that ERISA does, in fact, pre-empt Vermont’s all-payer claims database (“APCD”) statute as the statute applies to ERISA plans. Earlier, we included this case brief on the Source Blog. THE MAJORITY OPINION Justice Kennedy authored the majority opinion. He was joined by Justices Roberts, Thomas, Breyer, Alito, and Kagan. In its majority opinion, the Court acknowledged that Section 1144(a) of ERISA—that “any and all state laws insofar as they may …

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, …

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, …