FTC and Pennsylvania v. Penn State Hershey Medical Center, 838 F.3d 327 (3d Cir. 2016)
The FTC administratively challenged the combination of Penn State Hershey Medical Center and PinnacleHealth System, alleging that the merger would substantially reduce competition for general acute care inpatient hospital services in the area surrounding Harrisburg, Pennsylvania, leading to higher costs and reduced quality. The FTC and Pennsylvania filed a motion for preliminary injunction in federal court in Pennsylvania. The court denied the motion by the FTC and Pennsylvania in an opinion filed under seal, holding that the plaintiffs did not properly define the relevant geographic market. The FTC and Pennsylvania appealed to the 3rd Circuit, which reversed the district court and granted the preliminary injunction. The Third Circuit rejected the District Court’s reasoning on all counts: market definition, the relevance and persuasiveness of the parties’ 5-year contracts with payers, whether the claimed efficiencies were cognizable and potentially sufficient to overcome the government’s prima facie case, and how the equities should be balanced in an FTC preliminary injunction proceeding. The parties abandoned the merger. The 3d Circuit denied Pennsylvania’s claim for attorneys’ fees on the grounds that the relief was granted under FTC Act Sec. 13(b), which does not authorize attorneys’ fees to prevailing parties.
FTC and Illinois v. Advocate Health Care Network
The FTC administratively challenged the proposed merger of Advocate Health Care Network and NorthShore University HealthSystem, alleging it would create the largest hospital system in the North Shore area of Chicago. According to the complaint, the combined entity would operate a majority of the hospitals in the area and control more than 50 percent of the general acute care inpatient hospital services. The FTC and the State of Illinois filed for a preliminary injunction to prevent the merger before the FTC’s administrative trial. The district court denied the motion for preliminary injunction based on a finding that “plaintiffs ha[d] not shouldered their burden of proving a relevant geographic market.” The state and the FTC appealed. The 7th Circuit reversed and remanded the case. The court of appeals held that the district court’s geographic market finding was clearly erroneous, and approved the hypothetical monopolist test. The court also cited the “silent majority” fallacy, which overlooks the market power of the patients who are not willing to travel for hospital care.
Maryland et al. v. Perrigo Company, No. 1:04CV01398 (D.D.C. Aug. 17, 2004)
The FTC and states alleged that the companies had entered into a “pay-for-delay” arrangement, whereby Perrigo paid Alpharma to withdraw its generic version from the market for Children’t ibuprofen.According to the complaint, in June 1998, Perrigo and Alpharma signed an agreement allocating to Perrigo the sale of OTC children’s liquid ibuprofen for seven years. In exchange for agreeing not to compete, Alpharma received an up-front payment and a royalty on Perrigo’s sales of children’s liquid ibuprofen. The FTC received $6.25 million to compensate injured consumers. The states received $1.5 million in lieu of civil penalties. the parties were enjoined from future agreements.
Florida et al. v. Service Corporation International, No. A13CV1082LY (W.D. Texas Jan. 2, 2014)
SCI, the nation’s largest funeral home chain, sought to acquire Stewart Enterprises, another large funeral home chain. Seven states and the FTC entered into consent agreements with SCI specifying which funeral homes would be divested in 59 separate markets. In a separate consent agreement, SCI agreed to provide the state plaintiffs with the same notices, requirements for approval and compliance review as to divestitures and future acquisitions included in the FTC’s consent decree and to pay the state’s costs and attorneys’ fees..
Massachusetts v. J. Sainsbury, PLC, No. 99-2574A (Mass. Super. Ct. Suffolk Cty. Nov. 16, 2000)
State challenged the acquisition by J. Sainsbury of Star Markets supermarkets in Massachusetts. Defendant was required to divest 9 supermarkets, keep operating two others until a competitor opens up, and provide notice of future acquisitions. Consent decree was later modified to require only 8 divestitures.
Wal-Mart Stores, Inc. v. Rodriquez, No. 02-2778 (D.P.R.) and Estado Libre Asociado v. Wal-Mart Puerto Rico, Inc., No. 02-2847 (P.R. Ct. First Instance) (Feb. 28, 2003)
Puerto Rico challenged acquisition by Wal-Mart of supermarket chain in Puerto Rico. After the enforcement action was enjoined by the U.S. District Court, Puerto Rico appealed. Twenty states filed an amicus brief supporting Puerto Rico’s ability to challenge the transaction regardless of the actions of the FTC. While the appeal was pending, the parties entered into a settlement under which Wal-Mart would divest four supermarkets.
FTC and State of Ohio v. Promedica health System, No. 3:11CV0047 (N.D. Ohio Jan. 7, 2011)
State and FTC sought preliminary injunction in connection with an already consummated acquisition by Promedica of St. Luke’s hospital. The complaint alleged that ProMedica’s acquisition of St. Luke’s eliminated significant price and non-price competition between the two firms in both the general acute-care and inpatient obstetrical markets in Lucas County. According to the complaint, the acquisition also vests ProMedica with the ability to demand higher rates for services performed at its other hospitals as well, because the addition of St. Luke’s to the ProMedica hospital system has made ProMedica a “must-have” system for health plans seeking to do business in Lucas County, as plans can no longer offer consumers a viable provider network without including ProMedica’s hospitals. The preliminary injunction was granted, and the FTC proceeded with an administrative proceeding.
FTC and State of Idaho v. St. Luke’s Health System, No. 1:13-CV-00116-BLW (Jan. 24, 2014, D. Idaho)
The FTC and the Attorney General of Idaho filed suit to prevent the acquisition by St. Luke’s Health System of Idaho’s largest independent, multi-specialty physician practice group, Saltzer Medical Group. According to the joint complaint , the combination of St. Luke’s and Saltzer would give it the market power to demand higher rates for health care services provided by primary care physicians (PCPs) in Nampa, Idaho and surrounding areas, ultimately leading to higher costs for health care consumers. According to the joint complaint, St. Luke’s acquisition of Saltzer was anticompetitive and violated Section 7 of the Clayton Act and Section 48-106 of the Idaho Competition Act. It created a single dominant provider of adult primary care physician (adult PCP) services in Nampa, with the combined entity commanding nearly a 60 percent share of that market. In addition, an alternative network of health care providers that does not include St. Luke’s/Saltzer’s primary care physicians becomes far less attractive for employers with employees living in Nampa. The FTC and Idaho Attorney General allege that the newly combined primary care practices will give St. Luke’s greater bargaining leverage with health care plans, with higher prices for services eventually passed on to local employers and their employees. The parties consummated their transaction several months earlier, and a private antitrust complaint was filed by several competitors. Idaho and the FTC consolidated their suits for trial. The court held that the transaction was anticompetitive and that the acquisition should be unwound. The decision was affirmed by the Ninth Circuit
State of Nevada v. Renown Health, No. 3:12-cv-409 (D. Nev. Aug. 6, 2012)
Renown Health acquired the largest two cardiology practices in the Reno Nevada area, leaving it with 88 percent of the cardiologists in the geographic market. The settlement required Renown Health to suspend its non-compete agreements with the cardiologists until at least six cardiologists have terminated their employment by Renown. Renown will provide the Attorney General with advance notice of future acquisitions, implement a compliance program, and pay $550,000 to the AG office for fees and costs. The FTC had a parallel proceeding with similar relief.
Alaska v. Hilcorp Alaska et al.,No. 3An12-____ (Ak. Super. Ct. 3d Jud. Dist. Nov. 7, 2012)
Hilcorp Alaska LLC’s proposed to acquire Marathon Oil Company’s Cook Inlet, Alaska natural gas production, storage and pipeline assets for $375 million. Both the FTC and the state of Alaska expressed concerns about the acquisition because Marathon and Hilcorp are two of the three primary competitors for sales of natural gas in south-central Alaska, and account for over 90 percent of the natural gas produced in Cook Inlet and the acquisition would harm competition by diminishing the negotiating strength of the area’s primary purchasers, local utilities and industrial users. On the other hand, the acquisition could also alleviate concerns regarding local energy supply shortages. Existing fields in Cook Inlet are declining in production, and local utility demand is expected to exceed annual production within a few years. Because of this, the state has been actively working to encourage new investment in exploration and production in the Cook Inlet. The Alaska Attorney General entered into a consent decree with Hilcorp, which included (1) price caps on natural gas sold to local utilities and industrial users for the next five years; (2) a prohibition on selling Cook Inlet natural gas for liquefied natural gas export for five years; and (3) it will not knowingly sell Cook Inlet natural gas to other companies who intend to resell the gas for LNG export. The FTC decided to end its investigation as a result of the Alaska Attorney General’s action, in light of the concerns about energy scarcity in the future and the fact that only consumers in Alaska would be affected.
