Judge Denies Preliminary Injunction Against Medco, Express Scripts Merger

PITTSBURGH - A federal judge in Pennsylvania on April 25 ruled that pharmacies and pharmacy trade groups challenging the consummated $29 billion merger of pharmaceutical benefit management companies Express Scripts Inc. (ESI) and Medco Health Solutions Inc. were not entitled to a preliminary injunction...

3rd Circuit: Distributors, Not GPO Members, Are Direct Purchasers With Standing

PHILADELPHIA - Wholesale distributors, not health care providers, are direct purchasers of hypodermic products with standing to pursue claims that the manufacturer of those products violated the Sherman Act by entering into agreements with group purchasing organizations (GPOs) and other medical device...

Michigan Federal Judge Declines To Dismiss Antitrust Lawsuit

DETROIT - A Michigan federal judge on June 14 declined to dismiss an antitrust suit brought by one health insurer against another, saying the plaintiff's allegations met the threshold requirements to establish antitrust standing ( Aetna Inc. v. Blue Cross Blue Shield of Michigan, No. 11-15346, E...

Supreme Court Will Consider State-Action Immunity In Hospital Merger Case

WASHINGTON, D.C. - The U.S. Supreme Court on June 25 granted the Federal Trade Commission's petition for a writ of certiorari seeking review of an 11th Circuit U.S. Court of Appeals ruling that although a merger between two Georgia hospitals would substantially lessen competition or tend to create...

Court Affirms, Reverses Antitrust Case Over Payment For Chiropractic Services

DES MOINES, Iowa - The Iowa Supreme Court on July 27 affirmed in part and reversed in part a lower court decision granting judgment in favor of insurance companies in a putative class action brought by a group of chiropractic doctors who allege that they were wrongfully paid lower rates for their services...

Court: Competition Law Action Involving Nurse Staffing Levels Proceeds

SAN FRANCISCO - A California unfair competition law (UCL) action against nursing homes over staffing claims merely asks the court to decide whether misrepresentations exist; it would not force courts to regulate the health care industry, the First District California Court of Appeal held Aug. 15 ( Cameron...

Nonparty Subpoena In Antitrust Case Is 'Overly Burdensome,' Judge Rules

HAMMOND, Ind. - Blue Cross Blue Shield of Michigan (BCBS) cannot compel a nonparty hospital to produce documents in an antitrust action brought by the U.S. Department of Justice and the State of Michigan seeking to enjoin BCBS from including "most favored nation" (MFN) clauses in its contracts...

Pharmacists Fail To Show Sufficient Lost Sales; Price Discrimination Claims Fail

NEW YORK - A federal magistrate judge in New York on Aug. 16 granted summary judgment in favor of five manufacturers of brand name prescription drugs (BNPDs) on pharmacies' claims that the manufacturers offered discounts and rebates to the pharmacies' competitors but not to the pharmacies in...

FTC: Hospital Merger Not Shielded From Antitrust Law By State-Action Doctrine

WASHINGTON, D.C. - The 11th Circuit U.S. Court of Appeals erred in ruling that although a merger between two Georgia hospitals would substantially lessen competition or tend to create a monopoly, the state-action doctrine immunized the conduct from a challenge by the Federal Trade Commission, the FTC...

1st Circuit Affirms Dismissal Of Claims Against HMOs In Medicare Dispute

BOSTON - A First Circuit U.S. Court of Appeals panel on Sept. 7 affirmed the dismissal of a Medicare fee reimbursement suit, saying that the health maintenance organization defendants could compensate the plaintiff doctors in a manner of their choosing and that no antitrust violations occurred ( Carlos...

Health Insurer's Antitrust Claims Against Physicians May Continue, Federal Judge Rules

SAN JUAN, Puerto Rico - Humana Health of Puerto Rico Inc., a health insurer, sufficiently alleged that eight physicians violated federal and state antitrust laws by price-fixing, a federal judge in Puerto Rico ruled Sept. 17 in denying the physicians' motion to dismiss (Humana Health of Puerto Rico...

Blue Cross, Hospitals Ordered To Produce Documents In Federal Antitrust Suit

DETROIT - A Michigan federal magistrate judge on Oct. 1 ordered Blue Cross Blue Shield of Michigan and two nonparty hospitals to produce documents to the U.S. Department of Justice and the state in an action seeking to enjoin Blue Cross from including "most favored nation" (MFN) clauses in...

Antitrust Defendant Waived Right To Arbitrate Claim, 3rd Circuit Rules

PHILADELPHIA - A pharmacy benefit manager (PBM) waived its right to arbitrate antitrust claims against it by litigating the merits for 10 months, including its motion to dismiss, before filing a motion to compel arbitration, the Third Circuit U.S. Court of Appeals ruled Nov. 15, reversing a trial court...

High Court Hears Arguments On State-Action Doctrine In Hospital Merger Case

WASHINGTON, D.C. - The U.S. Supreme Court on Nov. 26 heard oral arguments regarding whether the state-action doctrine applied to immunize a merger between two Georgia hospitals from the Federal Trade Commission's challenge that the transaction substantially lessened competition or tended to create...

U.S. Supreme Court: Hospital Merger Is Not Immune From Antitrust Scrutiny

WASHINGTON, D.C. - The U.S. Supreme Court on Feb. 19 ruled that the state-action doctrine does not immunize the merger between two Georgia hospitals from the Federal Trade Commission's challenge that the transaction substantially lessened competition in the market for hospital services or tended...

DOJ, Michigan Move To Dismiss Antitrust Suit Against Blue Cross Over MFN Clauses

DETROIT - Following the Michigan Legislature's passage of bills prohibiting the use of "most favored nation" (MFN) clauses, the United States, Michigan and Blue Cross Blue Shield of Michigan on March 25 filed a joint motion to dismiss allegations that Blue Cross violated federal and state...

FTC Entitled To TRO In Merger Case, Georgia Federal Judge Rules

ALBANY, Ga. - A federal judge in Georgia on May 15 granted the Federal Trade Commission's motion to temporarily enjoin Phoebe Putney Health System Inc. from taking any further steps to consolidate Georgia hospitals and from making any price changes to existing contracts following the U.S. Supreme...

FTC, Hospitals Agree To Preliminary Injunction Halting Merger

ALBANY, Ga. - A federal judge in Georgia on June 5 approved the terms of a preliminary injunction agreed to by the Federal Trade Commission and Putney Health System Inc., enjoining the further integration of Georgia hospitals (Federal Trade Commission, et al. v. Phoebe Putney Health System Inc., et al...

Antitrust, Some ERISA Claims Dismissed From Wellpoint Reimbursement MDL

LOS ANGELES - A federal judge in California on July 19 dismissed antitrust and other claims alleging that WellPoint Inc. and other companies conspired to use a flawed database to set the rates for which out-of-network medical services (ONS) are reimbursed (In re: WellPoint Inc. Out-Of-Network "UCR"...

Ohio Federal Judge Grants In Part Motions To Compel Against Non-Party

DAYTON, Ohio - Non-party Community Insurance Co., doing business as Anthem Blue Cross and Blue Shield (Anthem), must produce certain documents regarding its deliberations not to contract with a medical center in the medical center's lawsuit claiming that it was denied contracts with managed care...

Judge: Provider Neither Competitor Not Consumer Of Insurer; Unfair Claim Fails

SACRAMENTO, Calif. - Claims that a health insurer misrepresented its power to authorize and provide coverage for treatment form the basis for a California unfair competition law (UCL) unlawful-prong claim, but because the provider is neither a consumer nor a competitor, its unfair-prong claim fails,...

Federal Judge Rules On Expert Testimony, Access In Merger Trial

BOISE, Idaho - The federal judge in Idaho overseeing the trial involving an antitrust challenge to a consummated merger between a hospital system and a physician group on Oct. 18 refused to exclude certain expert testimony regarding the impact of unwinding the merger and ruled that the Associated Press'...

Appeals Court Affirms Case Dismissal, Orders Transfer To Insurance Department

TRENTON, N.J. - A New Jersey appeals court in a Nov. 4 unpublished opinion affirmed the dismissal of chiropractors' challenge to a health insurer's policy provision limiting reimbursement of diagnostic imaging services but ordered the case transferred to the state insurance department for review...