In early February, Senator Amy Klobuchar, new Chair of the Senate Judiciary Subcommittee on Antitrust, Competition Policy and Consumer Rights, introduced the “Competition and Antitrust Law Enforcement Reform Act of...more
The year 2020 was an eventful one in the world of healthcare antitrust. The year began with the announcement of the precedent-setting settlement of the California Attorney General’s action against Sutter Health and ended with...more
1/21/2021
/ Antitrust Litigation ,
Antitrust Provisions ,
Antitrust Violations ,
Biden Administration ,
Blue Cross ,
Blue Shield ,
Federal Trade Commission (FTC) ,
Health Insurance ,
Hospital Mergers ,
McCarran-Ferguson Act ,
Multidistrict Litigation
After over 8 years of hard-fought litigation, the Blue Cross and Blue Shield Association, together with its 36 Blue Cross/Blue Shield members (“the Blues”), recently announced a proposed settlement of class action antitrust...more
The U.S. House of Representatives passed H.R. 1418, the “Competitive Health Insurance Reform Act,” by a voice vote on September 21. The legislation, which was introduced back in early 2019 by Congressman Peter DeFazio...more
The terms of a settlement that resolved antitrust litigation between the State of California and Sutter Health, the largest health system in Northern California, have now become public, almost two months after the settlement...more
1/7/2020
/ Ambulatory Surgery Centers ,
Anti-Competitive ,
Antitrust Litigation ,
Antitrust Provisions ,
Antitrust Violations ,
Competition ,
Compliance Monitoring ,
Contract Terms ,
Contracting Procedures ,
Corporate Structures ,
Enforcement Actions ,
Health Care Providers ,
Health Insurance ,
Healthcare Facilities ,
Insurance Contracts ,
Market Power ,
Restrictive Covenants ,
Settlement Agreements ,
Settlement Negotiations ,
Sutter Health
The Federal Trade Commission has issued orders to five health insurers and two health systems requiring them to provide information that will assist the FTC in studying the competitive effects of certificates of public...more
10/29/2019
/ Aetna ,
Anthem Insurance ,
Anti-Competitive ,
Antitrust Provisions ,
Basel Committee on Banking Supervision (BCBS) ,
Blue Cross ,
Blue Shield ,
Certificates of Public Advantage (COPAs) ,
CIGNA ,
Competition ,
Cooperative Agreements ,
Enforcement Actions ,
Federal Trade Commission (FTC) ,
Health Care Providers ,
Health Insurance ,
Investigations ,
Request For Information ,
United Healthcare Insurance Co.
Concluding one of the longest merger reviews in history, on September 4, Judge Richard Leon, District Judge for the District of Columbia, issued his final ruling in United States v. CVS Health, approving the proposed...more
9/5/2019
/ Aetna ,
AIDS ,
Antitrust Provisions ,
Competition ,
Corporate Sales Transactions ,
CVS ,
Department of Justice (DOJ) ,
Evidentiary Hearings ,
Final Judgment ,
Health Insurance ,
HIV ,
Medicare Part D ,
Pharmacies ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drug Coverage ,
Public Interest ,
Regulatory Standards ,
Settlement ,
Tunney Act
The District of Columbia District Court has again deferred its decision regarding whether to approve the merger between CVS Health and Aetna, a $69 billion transaction that was first announced back in December 2017. ...more
4/11/2019
/ Aetna ,
Antitrust Provisions ,
Competition ,
CVS ,
Department of Justice (DOJ) ,
Health Insurance ,
Joint Venture ,
Medicare Part D ,
Merger Controls ,
Pharmaceutical Industry ,
Pharmacies ,
Popular
Atrium Health (formerly known as Carolinas Healthcare System) scored a big victory in its defense of an antitrust class action on March 4, when the Court ruled that the plaintiffs in Benitez v. The Charlotte-Mecklenburg...more
In a filing with the Securities and Exchange Commission on November 26, CVS Health Corporation announced that it has received all of the regulatory approvals necessary to complete its acquisition of Aetna and that the...more
The United States Department of Justice Antitrust Division announced on November 15 that it was settling its antitrust lawsuit against Atrium Health (formerly known as Carolinas Health System)....more
The United States Department of Justice Antitrust Division announced on October 10, 2018, that it was conditionally approving the CVS/Aetna merger, a $69 billion transaction that combines the nation’s largest retail pharmacy...more
10/12/2018
/ Aetna ,
Antitrust Division ,
Antitrust Provisions ,
Competition ,
CVS ,
Department of Justice (DOJ) ,
Health Insurance ,
Medicare Part D ,
Pharmacies ,
Popular ,
Regulatory Standards ,
Retailers
Two pieces of related legislation that would prohibit so called “gag clauses” in contracts between pharmacists and health plans and pharmacy benefit managers (PBM’s) have been passed by both the Senate and the House....more
10/9/2018
/ Contract Terms ,
Disclosure ,
Drug Pricing ,
Health Insurance ,
Legislative Agendas ,
Medicare Advantage ,
Medicare Part D ,
Out-of-Pocket Expenses ,
Pending Legislation ,
Pharmaceutical Industry ,
Pharmacies ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
Trump Administration
On September 17, the United States Department of Justice (DOJ) Antitrust Division issued a “closing statement” in which it announced that it was closing its investigation into Cigna’s proposed acquisition of Express Scripts,...more
In December of 2017, CVS Health and Aetna announced their intention to merge. The transaction, if approved by regulators, would combine the country’s second largest pharmacy benefit manager (PBM), Caremark – a CVS subsidiary...more
In a somewhat unexpected but highly significant move, United States District Judge David Procter (Northern District of Alabama), who is presiding over the In re Blue Cross Blue Shield Antitrust Litigation (Case No....more
6/20/2018
/ Antitrust Litigation ,
Antitrust Violations ,
Blue Cross ,
Blue Shield ,
Geographic Markets ,
Health Care Providers ,
Health Insurance ,
Interlocutory Appeals ,
Market Allocation Scheme ,
Multidistrict Litigation ,
Per Se Rule ,
Price-Fixing ,
Putative Class Actions ,
Sherman Act
Three health insurers accused of having violated the antitrust laws in Academy of Allergy & Asthma in Primary Care v. Blue Cross Blue Shield of Louisiana, et al. (Eastern District of Louisiana), have filed motions seeking a...more
In what was a surprise result, on April 23, Judge William Smith (Chief Judge of the District of Rhode Island) reversed the “tentative” decision he had announced last November, in Stewart Health v. Blue Cross & Blue Shield of...more
On April 5, United States District Judge David Proctor (N.D. Alabama) granted partial summary judgment to the plaintiffs in the In re Blue Cross Blue Shield Antitrust Litigation, ruling that a network of trademark licensing...more
Recently, Cigna announced its plan to purchase pharmacy benefit manager (“PBM”) Express Scripts. In a March 14, 2018 letter to the chair of the House Committee on Energy and Commerce, Gregory Walden (R-Oregon), Congressman...more
Late last year, CVS and Aetna announced a merger, combining one of the nation’s largest health insurance companies and a large PBM, that being CVS’ Caremark division. The trend continues, as on March 8, Cigna announced its...more
On February 27, the House Judiciary Subcommittee on Regulatory Reform, Commercial and Antitrust Law held a hearing to consider the implications of the proposed CVS/Aetna merger. The transaction, valued at approximately $69...more