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​The Antitrust Practice Group addresses public and private enforcement activity and competition policy affecting all sectors of the health care industry, including health care providers, health insurers, and medical device and pharmaceutical companies. The Practice Group also maintains a discussion list; publishes email alerts, member briefings, and executive summaries; and sponsors webinars and in-person luncheons.

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You may access this content by joining AHLA and enrolling in Antitrust Practice Group.


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You can access this content by enrolling in Antitrust Practice Group.

You may access this content by Renewing your membership for Antitrust

You may access this content by joining AHLA and enrolling in Antitrust Practice Group.


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You can access this content by enrolling in Antitrust Practice Group.

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  • Health Insurance Antitrust Toolkit
    - Published on June 22, 2017

    The U.S. Department of Justice Antitrust Division (aided by a collection of states and the District of Columbia) prevailed in litigation challenging the two largest-ever proposed health insurance mergers in early 2017. The cases raised a number of important doctrinal issues, including how to define product markets in the health insurance sector and mechanisms for analyzing "upstream" market power in the purchase of hospital and physician services.

    The proposed merger of Aetna and Humana, which the parties announced in mid-2015, was blocked by the U.S. District Court for the District of Columbia in early 2017 after the Antitrust Division convinced the court that Medicare Advantage—a particular type of Medicare coverage for low-income senior citizens—and "traditional" Medicare are distinct product markets, and that the proposed merger between two of the five largest national health insurers would reduce competition for Medicare Advantage plans in hundreds of counties nationwide. The parties subsequently abandoned the transaction. In 2017, the U.S. District Court for the District of Columbia also blocked Anthem's attempt to purchase Cigna after finding that the merger would reduce competition in the sale of health insurance in a product market that consisted of large national employers (those with over 5,000 employees around the country). The district court rejected the parties' argument that the transaction would benefit customers because the parties would be able to negotiate lower rates with hospitals. The Court of Appeals of the District of Columbia Circuit upheld the district court's opinion, including the district court's rejection of the parties' efficiency defense, in a two-to-one decision.

    The key documents—the parties' pleadings and the courts' opinions—are here for your reference. These materials highlight the importance of understanding the nuances involved in defining a relevant product market: while the headlines focused on health insurance writ large, the litigation focused much more narrowly on, for example, the differences between Medicare and Medicare Advantage, or whether a relevant product market could be defined by a particular subset of customers (large national employers).

  • Clinical Integration Bibliography of Sources
    - Published in May 2013

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You can access this content by enrolling in Antitrust Practice Group.

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Upcoming:

Past:

Upcoming:

Past:

Upcoming:

Past:

February 9, 2016 12:00 PM-1:15 PM Eastern
February 9, 2016 12:00 PM-1:15 PM Eastern
July 1, 2015 12:30 PM-1:45 PM Eastern
July 1, 2015 12:00 PM-1:15 PM Eastern
April 16, 2015 12:00 PM-1:15 PM Eastern

Upcoming:

Past:

May 2, 2017 1:00 PM-2:00 PM Eastern
October 20, 2016 12:00 PM-1:00 PM Eastern
October 4, 2016 1:00 PM-2:00 PM Eastern
April 12, 2016 12:00 PM-1:00 PM Eastern
November 10, 2015 1:00 PM-2:00 PM Eastern
Task Forces are established for those health law topics that cross over several Practice Groups, and they provide collaborative, substantive resources for the benefit of the sponsoring Practice Groups' members.
Please note: You must be a member of the Antitrust Practice Group to enroll in this Task Force.
  • Accountable Care Organization Task Force
    The mission of the ACO Task Force is to provide members with a wide array of information relating to accountable care organizations, integrated care models, and other initiatives designed to improve quality and lower costs, for better population health. The ACO Task Force analyzes the impact and trajectory of ACO and other integrated care developments nationwide, including commercial ACOs, Medicaid ACOs, and the Medicare ACO programs.

    The mission of the ACO Task Force includes informing members of any new or updated regulations, waivers, and guidance relating to the main federal ACO programs, including the Medicare Shared Savings Program and the Pioneer ACO program, as well as to provide information on a broader array of issues integral to ACOs, integrated care systems, population health, and payment models.

    The ACO Task Force provides webinars, written material, and sponsored in-person programming pertaining to the relationship between ACOs and population health, as well as other topics germane to ACO formation and development. Since the ACO Task Force mission is so broad, it often partners with other AHLA Practice Groups to provide deeper insight into the unique legal and policy considerations for ACOs.

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Leadership

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Saralisa C. Brau Chair McKesson Corporation Washington, DC (202) 469-6273 Email
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Aimee E. DeFilippo Vice Chair - Educational Programs Jones Day Washington, DC (202) 879-7631 Email
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Ashley M. Fischer Vice Chair - Membership McDermott Will & Emery LLP Chicago, IL (312) 984-7766 Email
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Dionne C. Lomax Vice Chair - Publications Mintz Levin Cohn Ferris Glovsky & Popeo PC Washington, DC (202) 434-7419 Email
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Joshua H. Soven Vice Chair - Research & Website Gibson Dunn & Crutcher LLP Washington, DC (202) 955-8503 Email
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John Carroll Social Media Coordinator King & Spalding LLP Washington, DC (202) 626-2993 Email

 

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