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Competition Health Insurance

Arnall Golden Gregory LLP

Healthcare Providers Keep Singing the Blues About Unfair Reimbursement Rates But Blue Cross Blue Shield Won’t Change Its Tune

After more than a decade of litigation and more than $5 billion in settlements, the Blue Cross Blue Shield Association (“BCBSA”) and its affiliate insurance companies (the “BCBS Entities”) appear to be up to their old tricks....more

Arnall Golden Gregory LLP

Federal Court Permits MultiPlan Antitrust MDL to Proceed: Court Upholds Federal and State Antitrust and Consumer Protection...

On June 3, 2025, Judge Matthew F. Kennelly of the U.S. District Court for the Northern District of Illinois issued a sweeping ruling in In re MultiPlan Health Insurance Provider Litigation, largely denying motions to dismiss...more

King & Spalding

MultiPlan Algorithmic Pricing Antitrust Claims Survive Motion to Dismiss

King & Spalding on

On June 3, 2025, Judge Matthew F. Kennelly of the United States District Court for the Northern District of Illinois denied motions to dismiss antitrust claims in a multidistrict litigation (MDL) against MultiPlan, Inc. and...more

King & Spalding

Antitrust Concerns with Network Rental Agreements

King & Spalding on

How a common practice for healthcare payers can turn from negotiation tactic to anticompetitive collusion - What is a network rental agreement? Network rental agreements, also known as “network leasing” or “network...more

The Volkov Law Group

DOJ Adopts Aggressive Stance Against Algorithmic Coordination in Multiplan Antitrust Filing

The Volkov Law Group on

Recently, the Antitrust Division of the United States Department of Justice submitted a Statement of Interest in In re: Multiplan Health Insurance Provider Litigation, a class action presently pending before the United States...more

Burr & Forman

Provider and Health Care Facility Claim Submissions Now Open in $2.8 Billion Blue Cross Blue Shield Settlement

Burr & Forman on

Medical providers, including individuals, physician groups, hospitals, surgery centers, health systems and other health care facilities, may be eligible for a portion of a $2.8 billion settlement reached by the Blue Cross...more

Rothwell, Figg, Ernst & Manbeck, P.C.

Biosimilars at the Crossroads: A $234 Billion Opportunity or a Missed Chance for Healthcare Savings?

The U.S. stands at a crossroads in light of rising drug prices and it is unclear what the future will hold in answer to the rising drug costs. Biologic medicines have rapidly expanded available treatment options and accounted...more

Quarles & Brady LLP

Proposed Legislation Indicative of Continued Congressional Efforts to Expand PBM Oversight

Quarles & Brady LLP on

On December 11, 2024, a bill was introduced in the U.S. House of Representatives that, if enacted, would have substantial implications for pharmacy benefit managers (“PBMs”) and pharmacies across the country. Titled the...more

McCarter & English, LLP

Healthcare Consolidation and Private Equity: Public Input on Antitrust Healthcare Regulations

The Department of Justice Antitrust Division (DOJ), the Federal Trade Commission (FTC), and the Department of Health and Human Services (HHS) (together the Agencies) launched a cross-government agency request for information...more

Fennemore

Regulatory Landscape of Insurance Claims Denial Practices and Suggestions for a Path Forward to a Sustainable Healthcare Future

Fennemore on

In the wake of the December 4, 2024 fatal shooting of UnitedHealthcare’s CEO Brian Thompson, questions were raised about insurance claim denial practices. Several news outlets noted that UnitedHealth Group’s profits have been...more

Mintz - Antitrust Viewpoints

PBM Update: Special Edition - FTC Releases Second Interim Staff Report in PBM Inquiry

On January 14, 2025, the Federal Trade Commission (FTC) Office of Policy Planning released a second Interim Staff Report titled Specialty Generic Drugs: A Growing Profit Center for Vertically Integrated Pharmacy Benefit...more

McCarter & English, LLP

FTC Issues PBM Report Signaling Consolidation Is Impacting Pharmaceutical Prices

At a public meeting held on January 15, 2025, the Federal Trade Commission (FTC) summarized the Second Interim Staff Report (Second Report) stemming from its investigation into pharmacy benefit managers (PBMs) and their...more

ArentFox Schiff

Health Care Providers Should Seriously Consider Claims Under Two Antitrust Class Actions

ArentFox Schiff on

Now is the time for health care providers to consider participating in the recent Blue Cross Blue Shield (BCBS) antitrust class action settlement and the newly filed antitrust cases alleging widespread price fixing for...more

The Volkov Law Group

Antitrust Division AAG Outlines Need for More Aggressive Antitrust Enforcement in the Healthcare Industry

The Volkov Law Group on

In an interesting political twist, the difference in approaches to antitrust enforcement between Democrat and Republican Administrations has been narrowing. It used to be that the difference in party control of the Antitrust...more

MG+M The Law Firm

Blue Cross Blue Shield to Pay Record $2.8 Billion in Proposed Antitrust Settlement with Healthcare Providers

MG+M The Law Firm on

On October 14, 2024, a class of thousands of hospitals, physician groups and other healthcare providers filed a proposed settlement in a twelve-year antitrust lawsuit against the Blue Cross Blue Shield (BCBS) network. BCBS...more

WilmerHale

The Interplay: Key Decisions at the Intersection of Antitrust & Life Sciences - January 2024

WilmerHale on

Illumina Agrees to Unwind Acquisition of Grail Following Fifth Circuit Decision.  On December 15, 2023, the Fifth Circuit vacated the FTC’s order that Illumina unwind its acquisition of Grail—a developer of a multi-cancer...more

Williams Mullen

Change Can Be Hard: Will the DOJ Antitrust Division’s Loss of Its UnitedHealth/Change Merger Challenge Cause It To Reassess Its...

Williams Mullen on

​​​​​​​Earlier this year, Assistant Attorney General Jonathan Kanter, who leads the Department of Justice’s (DOJ) Antitrust Division, announced that the Antitrust Division would eschew settlements in merger challenges in...more

Cozen O'Connor

New York AG Files Antitrust Suit to Block Healthcare Acquisition

Cozen O'Connor on

On February 24, 2022, New York AG Letitia James and Minnesota AG Keith Ellison, along with the U.S. DOJ, filed an antitrust lawsuit in the United States District Court for the District of Columbia to block the proposed...more

Troutman Pepper Locke

Sixth Circuit Reverses Antitrust Preliminary Injunction Ordering Health Insurer to Keep Hospital in Its Network

Troutman Pepper Locke on

Introduction - On August 10, the Sixth Circuit issued its opinion in St. Luke's Hospital et al. v. ProMedica Health System, Inc., reversing an unusual preliminary injunction under Section 2 of the Sherman Act that ordered...more

Nelson Mullins Riley & Scarborough LLP

President Biden’s Recent Executive Order on Promoting Competition in the American Economy Highlights the Healthcare Sector

On July 9, 2021, President Biden issued an “Executive Order on Promoting Competition in the American Economy,” (the “Order”) which aims to drive down prices for consumers, increase wages for workers, and promote innovation...more

Bradley Arant Boult Cummings LLP

Healthcare News: Biden Administration Aims to Strengthen Competition Through Issuance of Sweeping Executive Order

President Biden issued Executive Order 14036 on July 9, 2021, calling for a “whole-of-government approach” to promote competition across many industries, including healthcare. The order establishes a White House Competition...more

Goodwin

Biden Executive Order Calls for Heightened Antitrust Scrutiny

Goodwin on

On July 9, 2021, President Joe Biden announced a broad executive order (the “Order”) intended to boost what it characterizes as stagnant competition across the U.S. economy. The Order, among other things, encourages the...more

Goodwin

Biden Executive Order Targets Competition in Healthcare, Life Sciences to Spur Economic Activity

Goodwin on

On July 9, 2021, President Joe Biden issued an Executive Order (the “Order”) designed to promote competition in the American economy. The Order describes the administration’s concerns with competition in several markets,...more

Akerman LLP - Health Law Rx

Klobuchar Antitrust Bill Could Have Significant Impact on Healthcare Industry

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

Cozen O'Connor

Repeal of McCarran-Ferguson Act — Ramifications for Insurance Clients

Cozen O'Connor on

Health insurance companies are now no longer immune from antitrust scrutiny for activities previously found to be “the business of insurance.” Last week, the Competitive Health Insurance Reform Act (CHIRA) was enacted,...more

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