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DOJ Launches Antitrust Investigation into Partners' Payor Contracts




by:
Jeffrey S. Spigel
King & Spalding LLP - Washington Office

 
May 6, 2010

Previously published on May 3, 2010

On April 19, 2010, the Department of Justice Antitrust Division initiated an investigation into possible anticompetitive behavior by Partners HealthCare System, one of the largest hospital and physician networks in Massachusetts. In a letter to Partners, the DOJ demanded documents related to Partners’ payor contracting practices in Massachusetts. Three insurers who contract with Partners, Blue Cross and Blue Shield of Massachusetts, Harvard Pilgrim Health Care, and Tufts Health Plan, also received requests for information and documents relating to Partners’ contracts.

According to the DOJ, the investigation will seek to determine whether Partners’ violated the Sherman Antitrust Act by using its market power to solicit higher payments from insurers. According to the Boston Globe, which broke the story on the investigation, the higher payments received by Partners and other large networks have received increased scrutiny due to regulators’ and legislators’ emphasis on reducing medical costs and insurance premiums. At the time of the DOJ’s letter, the Massachusetts state attorney general’s office had already opened an investigation into Partners’ payor contracting practices.

In the past decade, the DOJ has focused primarily on payor anticompetitive conduct, while allowing the Federal Trade Commission to take the lead on provider investigations. This investigation may represent the beginning of a more aggressive focus by the DOJ on possible anticompetitive conduct among providers.



 

The views expressed in this document are solely the views of the author and not Martindale-Hubbell. This document is intended for informational purposes only and is not legal advice or a substitute for consultation with a licensed legal professional in a particular case or circumstance.
 

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