Health Hippo: Antitrust

According to Alan Greenspan, "The world of antitrust is reminiscent of Alice's Wonderland: everything seemingly is, yet apparently isn't, simultaneously." In the health care arena, whether a particular transaction is or is not a violation of the antitrust laws may depend on the enforcement zeal of the current administration, the political cut of health reform, or even the judge assigned to a case.

Good News for health care partnerships! On August 28, 1996, DOJ and FTC issued important joint Statements of Antitrust Enforcement Policy in Health Care. The statements cover nine areas, including an Introduction and a Separate Statement of FTC Commissioner Christine A. Varney:

The two new statements on Physician Network Joint Ventures and Multiprovider Joint Ventures should be welcomed the health care industry, which has long criticized antitrust laws for impinging on collaborations that could improve patient care and competition between providers.

U.S. Code

Case Law

Blue Cross v. Marshfield Clinic (7th Cir. Sept. 18, 1995) (clinic did not posses market power to support Sherman Act violation - remanded for damages on division of markets claim)
BLUE SHIELD OF VIRGINIA ET AL. v. McCREADY (U.S. June 21, 1982) (no standing under Clayton Act Sec. 4). Thanks to Anthony D. Becker's Antitrust Case Summary Browser.
DOJ: Marshfield Clinic Brief (October 2, 1995) (requesting clarification of law applicable to market definition and analysis of "most-favored-nation" agreements)
Federal Trade Comm'n v. Ticor Title Ins., 504 U.S. 621 (1992). (State-action antitrust immunity not available under the title insurance regulatory schemes in Montana and Wisconsin)
JEFFERSON COUNTY PHARMACEUTICAL ASSOCIATION, INC. v. ABBOTT LABORATORIES ET AL. (U.S. February 23, 1983) (sale of pharmaceutical products to state and local government hospitals for resale in competition with private pharmacies not exempt from Robinson-Patman Act). Thanks to Anthony D. Becker's Antitrust Case Summary Browser.
JEFFERSON PARISH HOSPITAL DISTRICT NO. 2 ET AL. v. HYDE (U.S. March 27, 1984) (hospital's exclusive contract with firm of anesthesiologists did not violate § 1 of the Sherman Act). Thanks to Anthony D. Becker's Antitrust Case Summary Browser.

News & Reports

Health Care: Antitrust Enforcement Under Maryland's Hospital All-PayerSystem (Letter Report, 04/27/94, GAO/HEHS-94-81). One issue being raised in the debate over health care reform is how antitrust law should be applied to health care providers.
Health Care: Federal and State Antitrust Actions Concerning the Health Care Industry (Letter Report, 08/05/94, GAO/HEHS-94-220). GAO found that of 397 acute care hospital mergers reviewed by Justice and the FTC in the 13 year period of fiscal year 1981 through fiscal year 1993, less than 4 percent were challenged.
New Federal Antitrust Rules: Opportunities and Challenges for Physicians and Hospitals Physicians, hospitals and other providers should carefully review the Revised Statements and consider their application to the ongoing development and implementation of successful and lawful integrated delivery systems.
ABA Antitrust Law Section Antitrust regulation can affect any lawyer who represents business clients and corporations. TheSection offers the leading forum for ongoing analysis of policies and developments affecting competition and consumer protection law.
Antitrust & Certificates Of Public Advantage, BY TIM SIZE Competition and cooperation have never been seen as mutually exclusive concepts in the development of rural health systems, and these issues are becoming increasingly important on a number of fronts.
BALANCING "COMPETITIVE VS. COLLABORATIVE" FORCES In Wisconsin, policy concerns surrounding the issues of competition, cooperation, and antitrust enforcement in rural areas are becoming increasingly important on a number of fronts.
FTC News Releases The latest from the Federal Trade Commission.
HCFA: Press Releases The latest from the Health Care Financing Administration.
HCFA: Speeches Speeches from the Health Care Financing Administration.
HCFA: Testimony Testimony from the Health Care Financing Administration.
HCFA: Public Affairs
HSR: Local Markets and Systems: Hospital Consolidations in Metropolitan Areas This study examines the formation of local hospital systems (LHSs) in urban markets through the year 1992. We argue that a primary reason why hospitals join LHSs is to achieve improved positions of market power relative to threatening rivals.
The Role of Anititrust Immunity in the Washington State Health Care Market The Legislature directed the Attorney General to examine the issue of whether antitrust immunity should be granted to allow certain activities by health care providers and purchasers which might otherwise violate state or federal antitrust laws. This report presents the arguments for and against immunity and provides empirical evidence of the role competition has played in the health care service market in Washington.
RWHC: Antitrust & Certificates Of Public Advantage Competition and cooperation have never been seen as mutually exclusive concepts in the development of rural health systems, and these issues are becoming increasingly important on a number of fronts.
Vanderbilt Antitrust Policy Project The project links four types of information: antitrust case documents (complaints, opinions, and expert testimony); enforcement guidelines and speeches; economic bibliographies; and current antitrust issues in the news.
While Health Care Evolves, Antitrust Law Endures A reasonable level of understanding of basic antitrust concepts can help managed care practitioners avoid spending an unreasonable amount of time and money defending or explaining commercial actions.
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