In American Home Healthcare Servs., Inc. v. Floyd Mem'l Hosp. and Health Servs., No. 4:17-cv-00089-TWP-DML, 2018 WL 1172995 (S.D. Ind. Mar. 5, 2018), the district court ruled on a motion for judgment on the pleadings that a home healthcare service stated a Section 2 Sherman Act claim against a hospital system that owns a competing licensed home healthcare agency on the grounds that the defendant has allegedly installed mechanisms into the discharge planning process that increase the likelihood that it will receive patient referrals to its home healthcare agency. Specifically, the plaintiff alleges that the defendant requires physicians to take an extra step to select any home health provider besides the defendant's due to the fact that the only two choices on the computer drop-down menu are "Floyd" and "Other." As a result, plaintiff alleges that at least 64 percent of Medicare patients discharged from the hospital are referred in-network and that total self-referrals constitute no less than 70 percent of all referrals. The plaintiff alleged that the relevant product market is home health services following discharge from a hospital, and the relevant geographic market was the hospital. Although denying the defendant's motion for judgment on the pleadings, the district court denied the plaintiff's motion to dismiss a defamation claim premised upon a pre-litigation email sent by a physician to select others relating to the hospital's referral practices.