Antitrust Enforcement
Healthcare Merger Watch Q1 2023: Nationwide Cross-Market Merger Mania
Amy Y. Gu, Managing Editor March 15, 2023
In this first healthcare merger watch of 2023, we highlight some consolidation activities from the first quarter in the healthcare industry. In a trend that has continued in recent years, healthcare entities in the latest proposed and pending deals are increasingly exploring consolidation in new and innovative ways, across different geographic regions and involving different healthcare players in the industry. Even though federal and state antitrust enforcers often successfully challenge traditional, horizontal mergers and acquisitions, transactions involving cross-market consolidation are typically not challenged due to less straightforward legal and economic …
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DOJ Withdraws Decades Old Guidance on Antitrust Enforcement in Health Care
Amy Y. Gu, Managing Editor February 15, 2023
Since the Biden administration’s release of the Executive Order on Promoting Competition in the American Economy in July 2021, federal enforcement agencies have visibly advanced their efforts to step up enforcement actions and continued to push forward new enforcement agenda. In the latest development, the Department of Justice (DOJ) announced on February 3 the withdrawal of three federal enforcement policy statements, which removes some of the safe harbor protections that were established for healthcare entity activities nearly three decades ago. DOJ’s action is a direct response to the executive order’s call for …
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The Source Roundup: February 2023 Edition
Rachel Ng, Student Fellow February 1, 2023
Articles and reports published in the first month of 2023 saw an increased focus on the impact of consolidation as well as private equity investment in health care. Researchers also continued to examine factors impacting health care pricing and explored potential policy options available to the states to address provider prices, including a specific call for legislative intervention in the Western Pennsylvania market. Healthcare Consolidation Recent years saw an interesting shift in healthcare consolidation: mergers and acquisitions are becoming increasingly low-volume but high-value and cross-market. In Kaufman Hall’s report …
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Major Insurers See Antitrust Enforcement Action Headed to Appeals
Amy Y. Gu, Managing Editor January 17, 2023
We ended 2022 with an update on trends in healthcare provider consolidation and enforcement actions. In this inaugural 2023 issue of Litigation and Enforcement Highlights, we turn to the latest action in healthcare payer enforcement and litigation. Major insurers UnitedHealth and Blue Cross Blue Shield experienced similar antitrust woes lately, as both insurers saw their seemingly finalized lawsuits headed to the appeals court. UnitedHealth Merger Challenge Continues Post-Acquisition The UnitedHealth and Change Healthcare merger lawsuit grabbed headlines at the end of last year. The deal was officially consummated in …
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Healthcare Consolidation Q4 2022: Cross-Market Mergers Continue Apace
Amy Y. Gu, Managing Editor December 15, 2022
2022 has been an active year in healthcare consolidation as well as for merger challenges and enforcement. As we approach the year end, healthcare deals continued as many entities seek to close the transactions before the new year. Increasingly, as seen in the 4th quarter, healthcare deals are shifting to cross-market transactions, making review and enforcement efforts more challenging. In case you missed it, this final Litigation and Enforcement Highlights of the year will help you catch up on some of the cross-market deals in Q4 2022 that caught our …
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Office of Health Care Affordability: California’s Healthcare Cost Commission Gears Up for Implementation
Rachel Ng, Student Fellow and Amy Y. Gu, Managing Editor December 14, 2022
In the 2022 session, California enacted legislation to create the state’s healthcare cost commission, the Office of Healthcare Affordability (OHCA). As part of the Department of Health Care Access and Information (HCAI), OHCA is authorized to analyze the health care market for cost trends and drivers of spending and set and enforce cost-growth benchmarks for the state. It also has the authority to review and assess the impact of mergers, acquisitions, affiliations, and other healthcare transactions on price and competition. As OHCA prepares for its launch, the California Health Care Foundation …
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The Source and Various Stakeholders File Amicus Briefs Urging 9th Circuit to Reverse Jury Verdict of Sidibe v. Sutter Health on Appeal
Amy Y. Gu, Managing Editor November 15, 2022
See case page: Sidibe v. Sutter Health After the state action UEBT v. Sutter Health settled prior to trial, the Sidibe class action in federal court continued to shine the spotlight on hospital giant Sutter Health. In March 2022, a jury verdict in the Northern District Court of California cleared Sutter of anticompetitive allegations in this decade-long case. Class plaintiffs swiftly filed an appeal in the Ninth Circuit Court of Appeals to overturn the decision, citing inaccurate jury instructions and exclusion of key evidence that impacted the final outcome of …
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Recapping the 2022 California Legislative Session: What Was and What Wasn’t – Part 1: Regulating Competition and Ensuring Affordable Access to Care
Amy Y. Gu, Managing Editor November 7, 2022
Year two of California’s 2021-2022 legislative term came to an end last month as the Governor signed 997 bills into law and vetoed 169. The state considered healthcare bills that were rolled over from 2021 as well as new ones that were introduced in 2022. At the end of the 2021 session, The Source recapped noteworthy bills impacting healthcare price and competition that were enacted (see blog post). In the 2022 session, the legislature again made efforts to promote healthcare access and affordability in California through several legislative themes. In …
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The Source Roundup: November 2022 Edition
Rachel Ng, Student Fellow and Amy Y. Gu, Managing Editor November 1, 2022
In this month’s Roundup, we highlight some noteworthy articles and reports that discuss 1) state options for provider rate regulation and their potential pitfalls such as regulatory failure and regulatory capture; 2) consolidation trends in the hospital market and pharmaceutical industry; 3) price transparency efforts including compliance with the hospital and insurer transparency rules and the state-federal partnership to implement the No Surprises Act; and 4) drivers of national health spending. Provider Rate Regulation With the rapid consolidation of health care providers and highly concentrated insurance markets, consumer bargaining …
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DOJ’s Challenge of the UnitedHealth and Change Healthcare Merger: What Went Wrong and What Does it Mean?
Amy Y. Gu, Managing Editor October 17, 2022
The highly scrutinized merger of UnitedHealth Group and Change Healthcare went through in October 2022 shortly after obtaining court approval despite a legal challenge from federal and state regulators. The deal drew criticisms from industry groups and stakeholders largely amid concerns that it would give UnitedHealth access to sensitive data to gain competitive advantage in the market. The Justice Department-led challenge to the merger was seen as a test of the Biden administration’s intensified antitrust enforcement agenda, but the DOJ failed to convince the court to block the allegedly anticompetitive …
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