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 […]

October 12 marked the deadline for the California Governor to sign or veto legislation passed during the 2025 California legislative session, so we now know the fate of this year’s healthcare legislation.  Much of the session’s efforts were focused on ensuring support of Californians in the face of massive federal cuts to social programs, Los Angeles wildfires, a potential budget deficit of over $12 billion, and the state’s highly publicized push to get Proposition 50 passed, which will redraw Congressional district maps.  Lawmakers introduced an ambitious slate of bills aimed […]

On October 15, 2025, the California Hospital Association (CHA) filed suit against the California Office of Health Care Affordability (OHCA) (and affiliated defendants) over claims that OHCA’s spending targets are arbitrary, irresponsible and single out hospitals, and will severely disrupt hospital services, starving hospitals of needed resources. The California Legislature created OHCA in 2022 and authorized it: to analyze healthcare markets for cost trends and drivers of spending, to set and enforce cost-growth benchmarks for the state, and to review and assess the impact of mergers, acquisitions, affiliations, and other […]

On June 12th, 2025, Vermont Governor Phil Scott signed S0126 into law, in which the state aims to improve quality of care and healthcare access by stabilizing healthcare costs through Medicare-based price regulation, creating global hospital budgets, and establishing a more stable and high-quality state healthcare network.  The new law intends to do so through controlling costs for commercial insurance, managing hospital costs by using price caps, and overseeing and assessing administrative processes.  The law tasks the Green Mountain Care Board (GMCB) with accomplishing these objectives. Vermont’s current system for […]

Healthcare Consolidation Defining Health Care “Corporatization” (The New England Journal of Medicine) Erin C. Fuse Brown In this brief article, Fuse Brown draws on the prescient work of Paul Starr who, in his 1982 book the Social Transformation of American Medicine, foretold the coming of large healthcare conglomerates. Through consolidation, concentration, and increased focus on profits over patients, the author asserts that we have reached the “Gilded Age” of medicine, replete with dissatisfaction for all – producers, providers, and consumers. While Starr’s 40-year-old prediction has proven to be largely accurate, Fuse […]

Healthcare Cost Control State Health Care Cost Commissions: Their Priorities and How States’ Political Leanings, Commercial Hospital Prices, and Medicaid Spending Predict Their Establishment (The Milbank Quarterly) Brent D. Fulton, Daniel R. Arnold, Jordan M. Wolf, Richard M. Scheffler As healthcare costs continue to rise, states play an increasingly important role in addressing affordability and cost containment. In this Milbank Quarterly article, researchers examine the political and economic measures in the 17 states that have created Health Care Cost Commissions (HCCCs).  HCCCs are independent administrative bodies usually housed in the […]

Market Consolidation and Merger Review The Forgotten Anti-Monopoly Law: The Second Half of Clayton Act Section 7 (Texas Law Review) Robert H Lande, John M Newman, Rebecca Kelly Slaughter The authors of this article analyze the second prong of Section 7 of the Clayton Act, which prohibits mergers that “tend to create a monopoly.” In comparison to the well-known first prong that seeks to “substantially lessen competition,” the second prong is posited to wield more statutory power as it does not contain a requirement for a certain degree of harm […]

Department of Justice Looking Into United Health On February 21, 2025, the Wall Street Journal reported that the Department of Justice (DOJ) has launched a civil fraud investigation against UnitedHealth.  The investigation is centered on Medicare billing practices, with sources saying that UnitedHealth-employed physicians were trained to document higher revenue-generating diagnoses, even if that was not what patients were being treated for.  Additionally, the investigation is apparently looking into claims that UnitedHealth used software to suggest additional codes and offered bonuses to clinicians who coded for these additional diagnoses.  If […]

On December 23, 2024, Aetna (part of CVS Health) filed a lawsuit against Radiology Partners and its private equity backers in the U.S. District Court for the Middle District of Florida – Jacksonville Division.  The suit claims Radiology Partners, one of the nation’s largest imaging groups, manipulated the No Surprises Act (NSA) and its dispute resolution process to boost payments improperly.  Aetna’s filing called this a “multiphase healthcare fraud scheme” that defrauded Aetna of “tens of millions” of dollars. Update: On February 25, Radiology Partners filed two motions: one to […]

On January 10, 2025, Governor Newsom released his proposed California state budget for the 2025-26 term. Following last year’s $46 billion budget shortfall, the Governor’s new budget looked quite different this year. Specifically, the budget had no deficits, reporting a projected surplus of $363 million due to the state’s prediction that it will collect almost $17 billion more in revenue than was originally planned. In fact, this year is slated to go down as California’s second-largest state spending plan ever, at a value of almost $322 billion. Overview of the […]