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Recent lawsuits allege anticompetitive market allocation conspiracy by Blue Cross and Blue Shield

  • King & Spalding LLP
  • -
  • USA
  • -
  • April 24 2012

Two recent lawsuits allege that Blue Cross and Blue Shield entities in North Carolina and Alabama have violated federal and state antitrust laws by engaging in concerted action with other Blue Cross Blue Shield (BCBS) plans nationwide to divide geographic markets among them, which has allegedly resulted in reduced competition and higher rates charged to end customers for healthcare services

Department of Justice reaches settlement in first traditional Section 2 case since 1999

  • Kilpatrick Townsend & Stockton LLP
  • -
  • USA
  • -
  • March 2 2011

On February 25, 2011, the United States Department of Justice (DOJ) announced that it settled an antitrust enforcement action against United Regional Health Care System of Wichita Falls, Texas (United Regional) in which the agency alleged that United Regional had monopolized one or more markets for hospital services by entering into agreements with health insurers not to do business with United Regional's competitors

Health insurers’ motion to treble damages against pharmaceutical companies in antitrust case is granted

  • Edwards Wildman Palmer LLP
  • -
  • USA
  • -
  • February 7 2008

On June 1, 2005, after a jury trial lasting over three weeks, a jury found for Blue Cross Blue Shield of Massachusetts (“BCBS-MA”), Blue Cross Blue Shield of Minnesota (“BCBS-MN”), Federated Mutual Insurance Company (“Federated”), and Health Care Service Corporation (“HCSC”) (collectively “Plaintiffs”) against Mylan Laboratories Inc. and Mylan Pharmaceuticals Inc., Cambrex Corporation, and Gyma Laboratories (“Defendants”) on state law claims agreement in unreasonable restraint of trade; conspiracy in unreasonable restraint of trade; monopolization; and attempted monopolization in the Lorazepam active pharmaceutical ingredient (“API”) market, Lorazepam tablet market and in the Clorazepate API and tablet markets

Stakes raised in Blue Cross of Michigan “most favored nation” clause antitrust dispute as Aaetna jumps in as an antitrust plaintiff

  • Williams Mullen
  • -
  • USA
  • -
  • January 3 2012

Blue Cross Blue Shield of Michigan has been in litigation with the Department of Justice Antitrust Division for more than a year over BCM’s use of “most favored nation” clauses in its contracts with health care providers

New York radiology practice sues health care benefits administration firm contracted with major health care insurers alleging antitrust violations

  • Edwards Wildman Palmer LLP
  • -
  • USA
  • -
  • June 27 2008

A New York based radiology practice (the “Plaintiff”) filed an action in the United States District Court for the Eastern District of New York against a benefits administration firm, CareCore National, LLC, that provides services for insurers including Aetna, GHI, HIP, Healthnet, Healthfirst, and Oxford

FTC continues crackdown on unlawful collective fee negotiations

  • Baker & Hostetler LLP
  • -
  • USA
  • -
  • June 25 2009

The Federal Trade Commission's (FTC) aggressive enforcement of the antitrust laws regarding collective fee negotiations continued this month when the FTC sued a California independent practice association (IPA) for allegedly fixing the prices charged to healthcare insurers

Repeal of antitrust exemption gains traction as House and Senate Democrats reconcile healthcare reform bills

  • Edwards Wildman Palmer LLP
  • -
  • USA
  • -
  • January 8 2010

U.S. House Representatives Peter DeFazio, (D-OR) and Gene Taylor (D-MS) drafted a letter to House Speaker Nancy Pelosi (D-CA) in support of repealing the antitrust exemption under the McCarran Ferguson Act for health insurers and medical liability insurers

Partial repeal of the insurance antitrust exemption introduced as amendment to Senate healthcare bill

  • Edwards Wildman Palmer LLP
  • -
  • USA
  • -
  • December 4 2009

Senator Patrick Leahy (D-VT) filed an amendment to the Patient Protection and Affordable Care Act (H.R. 3590) (the “PPACA”) on December 1, 2009, that would repeal the exemption from federal antitrust laws for the health insurance and medical malpractice insurance industries

UnitedHealth fined $1 million for breach of merger consent decree

  • Williams Mullen
  • -
  • USA
  • -
  • June 28 2011

On June 23, the Nevada Attorney General’s office announced that it had fined UnitedHealth $1 million for breaching the terms of an antitrust Consent Decree that UnitedHealth had agreed to in 2008 to close its acquisition of Sierra Health, a rival health insurer

Aetna files antitrust suit against Blue Cross Blue Shield of Michigan concerning use of most favored nation clauses

  • King & Spalding LLP
  • -
  • USA
  • -
  • December 12 2011

On December 6, 2011, Aetna filed an antitrust lawsuit against Blue Cross Blue Shield of Michigan, the dominant insurer in Michigan