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Tag Archives: healthcare

DOJ challenges healthcare system’s use of anti-steering clauses

In its continuing fight against rising healthcare costs, the Justice Department (DOJ) has sued Charlotte, North Carolina’s largest healthcare system for using a common healthcare contracting tool, the anti-steering clause. U.S. and the State of North Carolina v. The Charlotte-Mecklenburg Hospital Authority, d/b/a Carolinas Healthcare System (CHS), Case No. 3:16-cv-00311, filed on June 9, 2016.

A few years ago, the DOJ attacked another healthcare contracting tool, the most-favored-nation clause, which insurers employed to guarantee they would receive the lowest rates on any given service. According to the DOJ, those clauses, when utilized by dominant healthcare systems, stifle competition and …

Are data breaches covered under insurance policies?

In defending against a class action case where patient information was found online for months without being secured, the insurance company was found to have a duty to defend the defendant, who held an insurance policy that covered the publication of patient information. The case, Travelers Indemnity vs. Portal Healthcare, is important because it’s one of the first decisions to rule on whether data breach litigation is covered under commercial insurance policies.…

United we fall? 6th Circuit holds that members of hospital network may not be a single entity under the antitrust laws

The U.S. Court of Appeals for the 6th Circuit recently issued an opinion with potential antitrust impact on joint ventures—in the healthcare realm and beyond. The case was originally filed by a Dayton-area surgical center, The Medical Center at Elizabeth Place, against a competing local hospital network, Premier Health Partners. The plaintiff claims that Premier Health Partners (Premier) and four of its member hospitals conspired under Section 1 of the Sherman Act – which requires concerted conduct between distinct economic actors — to put it out of business.

The four defendant hospitals had operated independently before joining in 1995 to …

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