Polsinelli has one of the country’s leading health care antitrust practices. Our antitrust lawyers have decades of experience in all aspects of the application of antitrust law to health care providers’ transactions and business issues. Our antitrust practice benefits from working closely with our full-service national health care practice, a deep bench of experts in all areas of health care law. Our interdisciplinary teams often include professionals in intellectual property law, payer contracting, data privacy and others. This approach allows us to give practical, industry-specific advice that recognizes the complex regulatory framework affecting health care.
Our experience includes:
Health Care M&A, including Government Merger Reviews & Litigation
- Lead antitrust counsel in dozens of recent hospital mergers, physician practice acquisitions and other provider affiliations, including some of the largest health care transactions in recent years.
- Advising parties on transaction structure, integration planning, Hart-Scott-Rodino filings and second requests.
- Defending government merger investigations and litigation, including as lead counsel for the acquiring hospital system in the Washington AG’s recent lawsuit seeking to enjoin and unwind two completed physician practice acquisitions (summary judgment for defendants on one acquisition; case settled with no divestitures).
- Protecting the rights of providers injured by anticompetitive conduct, including representing a hospital as trial witness for the FTC in its successful challenge to a physician practice acquisition (acquisition enjoined on the FTC’s motion).
Structuring Provider Joint Ventures, including Clinically Integrated Networks
- Forming and operating antitrust-complaint networks of competing providers.
- Creating, maintaining and documenting legally sufficient clinical and/or financial integration.
- Advice on payer contracting strategies, including gain sharing, risk sharing and pay-for-performance.
- Forming and operating provider-owned group purchasing organizations.
Representing Providers in Antitrust Disputes with Payers
- Representing providers, not payers, so we have no conflicts when disputes arise.
- Representing six health care systems in the pending national class action challenging market allocation and monopsony.
- Handling payer disputes relating to network formation, exclusive contracts, narrow-network and tiered plan designs and pricing.
Representing Pharmaceutical Companies
- Defending government litigation and private class actions alleging price-fixing.
- Antitrust advice on Hatch-Waxman issues, including patent litigation and settlements.
- Antitrust advice on pricing, marketing and product-development issues, including addressing efforts by branded drug makers to exclude generics.
Health Care-Specific Antitrust Compliance Programs
- Designing and implementing antitrust compliance policies tailored to each client’s needs.
- Conducting antitrust training and antitrust audits to identify risks and proactively solve antitrust compliance problems.
Related Capabilities
Publications
A Settlement, Not a Sigh of Relief: What the FTC’s Express Scripts Deal Signals for Enforcement Risk
The FTC’s newly announced settlement with Express Scripts marks a pivotal moment in the government’s campaign against pharmacy benefit manager pricing practices—and it should be read as more than a single-company resolution.
While Express Scripts avoided an adjudicated ruling, the 10-year deal requires extensive operational changes that the FTC has framed as correcting practices it believes have driven artificially high drug prices, particularly for insulin. The agency has labeled the settlement “landmark,” and it offers a clear preview of the compliance standards regulators are likely to demand across the industry.
What the FTC Is Signaling
The settlement mandates, among other things, that Express Scripts:
Stop preferring high wholesale acquisition cost drugs over lower-priced equivalents;
Shift patient cost-sharing to reflect net prices rather than list prices;
Unwind
Read MoreHealth care M&A goes back to the antitrust future
Arindam Kar, Shareholder in our Antitrust Group, discusses potential changes on the horizon for healthcare M&A deals under the new administration.
Read More