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
People ex rel. Madigan v. Carle Clinic Association, P.C.
State alleged two clinics conspired to boycott Medicaid patients by adopting identical policies through which they refused to accept Medicaid patients: (1) who were not already registered with the clinic or (2) who had not seen a clinic physician for at least three
years. They allegedly sought to increase the Medicaid reimbursement rates and to accelerate reimbursement payments from the State of Illinois. Settlement reached in which Carle will increase Medicaid patient load and pay local health centers who had to treat more patients because of the policies. In April 2009, Christie Clinic settled with the state, agreeing to increase the number of Medicaid patients it will accept for primary health care services to 8,500 over the next
three years; will not deny Medicaid patients primary care services because of existing medical debt incurred from March 2003 through September 2007 – the period during which these patients were turned away as qualified Medicaid patients and were charged for health care services; and wil pay, over three years, $120,000 to Frances Nelson Health Center to help fund its primary care services for low-income patients
and $34,000 to the Champaign Urbana Public Health District to help pay for its dental program for low-income children. Both Christie and Carle Clinics are committed to accept more than 17,000 Medicaid patients in the intial year, growing to 20,000 over the next three years.
Arizona v. Arizona Hospital and Healthcrae Association
Arizona and USDOJ alleged that hospital trade association fixed the price of nursing services from temporary nursing agencies as participaitng hospitals, which comprised 80 percent of hospital beds in Phoenix and Tucson. Inunctive relief prohibiting conduct and implementing compliance program.
In re UnitedHealth Group Incorporated and Sierra Health Services, Inc.
Coordinated US DOJ and Nevada Attorney General investigations of health insurance merger, results in separate settlements filed in separate courts. Both settlements require divestiture of business division, yet Nevada Attorney General provides additional relief.
Connecticut v. HealthDrive Corporation
Provider of allied healthcare professional services (dental, optometric, audiological, podiatric) to long-term care facilities and their residents settled Attorney General’s claims of unlawful tying (of podiatric services to dental services) via entry of an Assurance of Voluntary Compliance, which eliminated the tying practice.
In re Healthcare Research and Development Institute LLC
Investigation led by CT AG into certain anticompetitive behavior carried out by HRDI in the healthcare service and supply industry and the use of undue and improper influence in the healthcare purchasing process. HRDI agreed to dissolve, but it is permitted to reorganize with only health care executives as members. HRDI also must pay Connecticut $150,000.
In the Matter of Baycare Health Partners, Inc., No. 94-5653 (Superior Court of Mass., Suffolk Cty., Oct. 4, 1994)
State was concerned about contractual provisions in proposed Phyisician Hospital Organization (PHO) which would require participating physicians to bring new contract opportunities with health plans to the PHO first.
U.S. and Connecticut v. Healthcare Partners, Inc., No. 3:95CV01946 (D. Conn. 1995)
After join investigation,United States and Connecticut alleged that sole hosptial in Danbury Connecticut conspired with physicians to preclude entry of managed care plans into the market. Consent decree was entered.
In the Matter of Blue Cross Blue Shield of Massachusetts, No. 95-3591A (Mass. Super. Ct. Suffok Cty. June 22, 1995)
State settled (through Assurance of Discontinuance) charges that Blue Cross Blue Shield of Massachusetts solicited or agreed to solicit a boycott of Hillcrest Hospital in Pittsfield, Massachusetts while Blue Cross was in contract negotiations with another Pittsfield hospital.
Utah v. University of Utah, Civ No. 940901730M (Utah D. Ct., 3rd Dist., Salt Lake Cnty. filed 3/16/94).
State settled allegations against state university, which had been involved in a conspiracy by eight Utah hospitals to fix wages of registered nurses and fix physician prices.