We kick off the new year with a handful of new developments in healthcare litigation and enforcement that transpired at the end of 2020. In price transparency, a pair of legal challenges intended to block transparency efforts in drug pricing and hospital pricing, respectively, were denied by the circuit courts. On the antitrust front, the Federal Trade Commission saw both victory and defeat in its challenges of proposed mergers that would lessen competition in the healthcare markets.   Judges Refuses to Block California’s Drug Pricing Transparency Law SB 17 On …

The Source kicked off the New Year with a trio of blog posts in the Health Affairs Blog that highlights the Database of State Laws Impacting Healthcare Cost and Quality (SLIHCQ). The SLIHCQ Database was developed in partnership with the Catalyst for Payment Reform (“CPR”) and is an interactive tool that hosts ongoing state legislative efforts to implement healthcare reform. It is intuitively designed to allow policymakers and other stakeholders to customize and filter their searches by key issue and state. In collaboration with CPR, The Source Executive Editor Jaime …

Happy New Year Source readers! In this month’s roundup, we take a look back at the last health policy articles of 2020 and look ahead to what 2021 holds. These pieces examine the continuing rise of national healthcare spending, the impacts of health market consolidation under the guise of healthcare delivery integration, the importance of state-level all-claims payer databases (APCDs), and the potential healthcare system reforms under the Biden administration.   Healthcare Costs Underpinning most topics in this roundup is the issue of healthcare costs, prices, and spending. According to …

This legislative session, California Governor Gavin Newsom signed AB 890, legislation that expands the existing scope of practice laws for nurse practitioners (NPs).[1] The law brings California in line with over half of the states in the U.S. by permitting NPs to practice independently and to the full extent of their training and education. As demand for healthcare workers continues to surge with the number of COVID-19 cases in this country, AB 890 helps pave the way for more healthcare providers to provide crucial care where it is needed. This …

As the COVID-19 pandemic continues to ravage the nation, it has put economic stress on smaller healthcare providers, giving larger health systems the opportunity to gain market power through more rampant merger and acquisition activity. In response, the Federal Trade Commission and the Department of Justice also stepped up their antitrust enforcement efforts. In this year-end Litigation and Enforcement Highlights issue, we round up federal enforcement challenges of provider mergers in 2020 and look at the latest status of these actions.   Jefferson Health/Albert Einstein (Pennsylvania) The Federal Trade Commission …

In a new 60 Minutes episode aired on 12/13/20 (S53 E15), CBS interviews California attorney general Xavier Becerra in its investigation of anticompetitive practices by Sutter Health that led to higher health care costs in California. Watch the story here.

In the final monthly roundup of this tumultuous year, we highlight articles and reports that examine 1) rising and varying healthcare costs and their pronounced impact on Americans during the pandemic; 2) antitrust enforcement challenges of private equity partial ownership and joint ventures; 3) continued success of the Affordable Care Act in both marketplace participation and coverage protections for Americans amidst the pandemic; and 4) value-based pricing for COVID-19 treatment and vaccines.   Rising and Varying Healthcare Costs Increase Burden to Americans In the Kaiser Family Foundation report How costly …

Editor’s Note: An abbreviated summary of this case appears in the research report “Preventing Anticompetitive Contracting Practices in Healthcare Markets”, which provides a detailed analysis of anti-tiering/anti-steering clauses, including economic justification and procompetitive use and states that have restricted its use in healthcare contracts.   The antitrust case against Sutter Health in California has drawn the attention of state regulators and policymakers across the country, spawning legislative reform efforts to curb dominant hospitals’ market power. Prior to this, an enforcement action against Atrium Health, a large health system on the …

On November 13, The Source on Healthcare Price & Competition and the UC Berkeley Petris Center jointly hosted a virtual convening of some of the leading experts in law and economics in a workshop to review and evaluate current findings of our collaborative research series “The Role of States in Promoting Competition in Healthcare: A Legal and Economic Analysis.” Our research analyzes how state merger review authority and regulation of contracts between providers and insurers affect the price of healthcare services and insurance premiums. The interactive workshop, supported by Arnold …

This is part of a series of summaries that highlight notable legislation and initiatives in health policy and reform of all 50 states. Check back on The Source as we roll out additional states each week. See District of Columbia page. The District of Columbia established its own health insurance exchange under the Affordable Care Act, whereas most states maintain exchanges facilitated by the federal government. In provider market oversight, the District of Columbia requires the State Health and Planning Development Agency (SHPDA) to issue a certificate of need for …