County Mental Health Board Is Immune From Antitrust Suit, Federal Judge Rules

ROCKFORD, Ill. - An action alleging that a community mental health board established by McHenry County, Ill., violated federal antitrust law by demanding recoupment of fees paid from an organization that the board found engaged in improper billing practices is barred by the state-action immunity doctrine...

Health Insurance Purchasers May Drop $4.8M Settlement Of Antitrust Litigation

PITTSBURGH - A federal judge in Pennsylvania on May 7 permitted purchasers of health insurance from Highmark Inc. to withdraw their motion for preliminary approval of their settlement with Highmark of their antitrust claims, where the purchasers argued that Highmark failed to disclose information that...

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...

Pharmacies' Monopsony Challenge To Medco, Express Scripts Merger Is Dismissed

PITTSBURGH - A federal judge in Pennsylvania on June 28 dismissed claims made by pharmacies and pharmacy trade groups that the consummated $29 billion merger of pharmaceutical benefit management (PBM) companies Express Scripts Inc. (ESI) and Medco Health Solutions Inc. gave the merged PBMs monopsony...

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"...

California Federal Judge Partially Grants Arbitration In Drug Trade Secret Suit

SAN FRANCISCO - A California federal judge on July 22 granted in part and denied in part a motion to compel arbitration in a class action lawsuit, alleging that a pharmacy benefit management company (PBM) and its related entities made unauthorized disclosures of customer information (Uptown Drug Company...

FTC Settles Charges That Georgia Hospital Merger Is Anti-Competitive

WASHINGTON, D.C. - The Federal Trade Commission and the Hospital Authority of Albany-Dougherty County and Phoebe Putney Health System Inc. on Aug. 22 settled FTC charges that the acquisition of Palmyra Park Hospital harmed competition in six Georgia counties (In the Matter of Phoebe Putney Health System...

Ill. Federal Judge Dismisses Antitrust Claims Against Health Insurer, Hospital

EAST ST. LOUIS, Ill. - An Illinois federal judge on Aug. 26 dismissed antitrust claims brought by an outpatient surgery center against a health insurance company and a corporation owning multiple hospitals in Illinois, holding that the plaintiff failed to properly show a relevant market (Marion Healthcare...

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...

California Federal Judge Remands Reimbursement Suit, Finds No Preemption Exists

SAN JOSE, Calif. - A California federal judge on Dec. 16 remanded a reimbursement dispute to state court, holding that the Employee Retirement Income Security Act did not preempt the state law claims (Bay Area Surgical Management v. United Healthcare Insurance Co., et al., No. 13-2512, N.D. Calif.; 2013...