Antitrust Enforcement
Post Update: Parties & Court Still Working Out How Much Confidentiality Providers’ Antitrust Filings Will Get
Anne Marie Helm, Managing Editor January 7, 2016
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, …
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Most-favored Nations Clauses Come Back to Haunt Blue Cross Blue Shield of Michigan
Anne Marie Helm, Managing Editor August 27, 2015
The BC/BS multi-district litigation over alleged market allocation and other antitrust violations by the insurer and their Association caught our eye again this week when Defendant Blue Cross Blue Shield of Michigan filed a motion to preclude certain discovery. The discovery requests BCBSM objects to relate to Aetna’s lawsuit against BCBSM that settled in May after five years in federal court in Michigan. As you recall, Aetna’s antitrust suit against Blue Shield of Michigan that began with this 2011 complaint had been set to go to trail on May 26, 2015, but …
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Update: Daughters of Charity Gets $250M to Stay Afloat
Anne Marie Helm, Managing Editor July 17, 2015
Update (July 17, 2015): The Daughters of Charity hospitals, which sought purchasers due to financial hardship earlier this year, only to be impeded by the California AG, whose onerous conditions were the death knell to Prime’s proposed acquisition, have secured some help in the form of a $250 million capital injection, according to early reports. Private equity firm BlueMountain Capital Management will provide the investment. See below for our earlier posts on the Daughters situation: Update (March 10, 2015): Today Prime announced that it would not go forward with its proposed …
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Federal Merger Enforcement Timeline
Anne Marie Helm, Managing Editor July 6, 2015
4-28-17: 2nd Circuit affirms District Court Decision to Block Anthem-Cigna Merger On April 28, 2017, a divided panel of the Second Circuit Court of Appeals affirmed the US District Court’s decision that sided with the Department of Justice (DOJ), which argued that the proposed merger violated Section 7 of the Clayton Antitrust Act. Anthem Inc. announced on May 12, 2017 that it would no longer seek to acquire Cigna Corporation. 2-08-17: District Court Blocks Anthem-Cigna Merger On February 8, 2017, the United States District Court for the District of Columbia blocked the proposed merger between …
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Michigan Hospitals Settle with DOJ/State AG Over Scheme Not to Compete
Anne Marie Helm, Managing Editor July 1, 2015
At the end of last month, the Antitrust Division of the Justice Department and the Michigan Attorney General’s Office filed a civil complaint against four Michigan hospitals, alleging the providers had agreed not to compete with one another in violation of Sherman Act §1 and Michigan state law. DOJ and the Michigan AGO filed a proposed settlement (in the form of a proposed final judgment) simultaneously with that complaint, which means that the parties had reached a settlement before either document was filed. This is common practice for the government …
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Is M&A for Insurers Bad? Ask the Blue Cross Plaintiffs.
Anne Marie Helm, Managing Editor June 25, 2015
The focus of most antitrust concerns in healthcare over the past few years has been provider consolidation and provider market power. But, lately all eyes appear to be on insurers, who, as The Source tweeted on June 16 and the Wall Street Journal echoed three days later, followed by CNBC yesterday, seem to have caught merger fever (ok, we said “consolidation fever,” and we said that they seemed to have caught it from the providers, whereas they didn’t trace the fever’s origin). As the five largest insurers, United Health, Cigna, …
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Issue Brief: Most Favored Nation Clauses
Source Fellow June 19, 2015
*Editor’s Note (September 2020): See updated research paper on anticompetitive contract clauses including most-favored-nations clauses for more detailed analysis: “Preventing Anticompetitive Contracting Practices in Healthcare Markets”. By: Evan Sznol, Source Fellow Introduction: What is a Most Favored Nations Clause? The contract provision known as the most favored nations (“MFN”) clause is a promise obtained by a buyer from a seller that the seller will not give a better price to another buyer. In the healthcare context, an MFN clause typically manifests as a provision within a health network plan contract …
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Update on 9th Circuit Appeal of Antitrust Case Against Sutter
Anne Marie Helm, Managing Editor June 8, 2015
June 2015 Update: Since our last post on this case, Sutter filed its answering brief, and the plaintiffs filed their reply in the Ninth Circuit Court of Appeals. As timing would have it, between the answering brief and the reply, the Ninth Circuit decided the St. Luke’s appeal, another case that focused on geographic market definition in a healthcare market, in February of this year (see our blog post on that case). Accordingly, the Sidibe plaintiffs relied heavily on St. Luke’s in their reply brief to argue for a market definition …
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April Articles & Reports Roundup
Jaime S. King, Executive Editor May 1, 2015
While April brought us little in the way of showers, it did offer a nice range of articles and reports that focus on competition in health care markets and payment reform initiatives, including accountable care organizations (ACOs). This issue of the Roundup will tackle payment reform initiatives first, then move on to competition, and wrap up with a handful of articles examining state initiatives and opportunities. Payment Reform Initiatives The April academic literature examined the ability of payment reform initiatives, including payment for performance, reference pricing, and provider risk sharing …
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How to fix our hospital pricing problem (and how not to)
Guest Author April 15, 2015
By Guest Blogger: Erin C. Fuse Brown, JD, MPH We are pleased to publish another excellent post by Professor Fuse Brown, originally published here by the Center for Law, Health & Society! The post: Last month, Slate columnist Reihan Salam wrote a provocative article about outrageous hospital prices that are driven, according to Salam, by greed, avarice, and market power. Salam gets a few things dead right, namely his diagnosis that we have a massive hospital pricing problem that is bleeding us dry and that the problem is largely caused by growing hospital market power. However, he misses the …
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