May 2018
On April 23, a federal court in Rhode Island fired a warning shot over the bow of dominant health insurers across the country, holding that a refusal to negotiate in good faith with a health care provider that focuses population health management in an attempt to block its entry could violate Section 2 of the Sherman Act.
The court denied Blue Cross & Blue Shield of Rhode Island’s motion for summary judgment on claims that it blocked the acquisition of a financially-troubled Rhode Island hospital, Landmark Medical Center, by a Massachusetts hospital system, Steward Health, which sought to bring its innovative population-health-management business model to Rhode Island.  According to the Court, a reasonable jury could conclude that Blue Cross’s aggressive negotiating approach with Landmark was “designed to kill” Steward’s acquisition of Landmark and, with it, the entry of a disruptive threat to Blue Cross’s dominance.
Finally, in a separate order on May 15, the court denied Blue Cross’s attempt to appeal the denial of its motion for summary judgment on the grounds that an immediate interlocutory appeal to the First Circuit would not “materially advance the ultimate termination of the litigation.”

To view the full e-alert, click here.