Q2 2022: Antitrust Enforcement Actions Flourish Against Healthcare Consolidation and Anticompetitive Contracting
It's been a busy month in healthcare antitrust land, both for federal regulators and private plaintiffs, as we saw an explosion of enforcement actions challenging both proposed mergers and anticompetitive conduct that stemmed from previous mergers. From New Jersey to Utah, large health systems such as HCA are being increasingly scrutinized and coming under fire for garnering and using their market power in anticompetitive ways. Merger Challenges Fresh from its appeals court win in the Hackensack Meridian and Englewood merger challenge, the Federal Trade Commission (FTC) is continuing its momentum and kicking off [...]
HCA Healthcare, the second largest health system with six hospitals in the Wasatch Front region of Utah, proposed to acquire five hospitals from Steward Health Care, the fourth largest system in the region. According to the FTC, the two rival hospital systems vigorously compete with each other to keep costs down. The proposed merger is likely to substantially lessen competition for general acute care services in healthcare markets of at least four counties that are already high concentrated. Specifically, the merger would increase the Herfindahl-Hirschman Index (“HHI”) by more 200 points to 2,500, which [...]
Associate Physician License Amendments. This bill repeals a restriction that an associate physician may only practice primary care services; and amends provisions relating to the collaborative practice arrangement for an associate physician.
Prescription Drug Amendments. This bill modifies provisions relating to reimbursement and contracting for pharmaceutical drugs; enacts new prohibitions on pharmacy benefit managers regarding drug pricing and contracting for 430B entities and 340 drugs; prohibits a pharmaceutical manufacturer from engaging in certain types of actions with respect to pharmacies and 340B entities.
Telehealth Amendments. This bill amends the Telehealth Act and the Online Prescribing, Dispensing, and Facilitation Licensing Act; amends provisions related to a telehealth provider establishing a provider-patient relationship; amends provisions to related to a telehealth provider providing a patient's medical record to another health care provider; addresses prescribing by a provider who uses only asynchronous interaction to establish a provider-patient relationship with a patient.
Prescription Cost Amendments. This bill enacts provisions relating to cost sharing for certain prescription drugs; prohibits a health benefit plan from excluding payments made on behalf of an insured when determining whether the insured has satisfied the plan's cost sharing requirements.