Significant Antitrust Issues for Healthcare & Pharma Industries: What Lies Ahead in 2017 & Beyond
Due to the significant changes in the healthcare markets, regulatory developments, technological advancements, financial pressures and other uncertainties, stakeholders in healthcare must carefully consider their legal rights and exposure in forming new entities, alliances, insurance plans and programs, independent practice associations and consolidations among healthcare providers and institutions. The complexity of antitrust laws as applied to healthcare has in recent years pushed the Federal Trade Commission (FTC) and the Department of Justice (DOJ) to devote significant resources to monitoring healthcare related businesses and to prevent anticompetitive effects in the healthcare industry. Aside from FTC and DOJ, enforcement actions from other regulating bodies such as state Attorney Generals, consumer class actions and private actions by competitors are a source of potential liability for stakeholders in the healthcare industry. Antitrust laws providing for treble damage and attorneys’ fees to successful plaintiffs make this an important area to understand for potential plaintiffs and defendants in the healthcare industry.
In this LIVE Webcast, a seasoned panel of thought leaders assembled by The Knowledge Group will provide the audience with an in-depth analysis of the significant antitrust issues for healthcare and pharma industries. Speakers will also highlight legal insights and recent developments with regard to this still evolving topic.
Key topics include:
- Overall antitrust concepts and application to healthcare
- Significant Court Decisions
- Government Enforcement and Private Actions
- Recent Trends and Developments
- Opportunities for Competitors and Consumers to protect competition
- Best Strategies for insurers, providers and institutions to Avoid Potential Risks and Pitfalls
SEGMENT 1: Fred Taylor Isquith, Sr., Partner
Wolf Haldenstein Adler Freeman & Herz LLP
- Overview of the issue and why the antitrust laws come into play in so much litigation
- Summary: Why class actions are often used and how their challenges to plaintiffs and defendants
SEGMENT 2: William Thomashower, Attorney
Schwartz & Thomashower LLP
- Provider groups of independent practitioners or hospital exclusive contracting, and requirements to avoid antitrust exposure, such as integrated independent practice association, with shared economic risks (Capital Imaging v. Mohawk):
- Exclusive contracting by or with hospitals or insurance plans; effect on competition (price, quality, patient care/continuity and output of services);
- Hospitals or Group sharing of or agreeing on matters affecting competition, such as price, division of markets and limitations on services. (NY v. St. Francis Hospital)
- Professional associations of practitioners – limitations on control of the market via price control (Arizona v. Maricopa), rulemaking or disciplinary proceedings affecting competitors’ right to practice (FTC v. Indiana Federation).
- Medical staff/medical privileges determinations and peer review
- Management benefit groups and requirements to avoid antitrust exposure.
- In this category are groups such as e.g. pharmacy benefit managers (PBM’s), radiology benefit management, a chiropractic management, etc. (e.g. multiple cases v. CareCore National). These sometimes have interplay with health insurers, if they either conduct or have to approve utilization reviews for the insurers or are also simultaneously competing providers, or have control over provider access to insurance coverage.
- Insurer/Managed Care Organization contracts and restrictions; selective contracting and payor control of participating providers in regard to price, billing or services offered.
- Substantive antitrust standards, primarily Sherman Act Section 1 (agreements in restraint of trade, whether per se or under Rule of Reason, requiring adverse impact on competition such as price and quality); and Section 2 (three types of offenses: monopolization, attempts to monopolize and conspiracy to monopolize);
- Types of challengers
- Government regulators (FTC, DOJ, State AG’s)
- Disadvantaged competitors such as providers or hospitals
- Other private antitrust plaintiffs, or consumer/patient/insured class actions
SEGMENT 3: Dr. Samuel Weglein, Vice President
- Discussion of recent healthcare provider mergers, with a focus on
- Geographic market definition
- Efficiencies/ACA/failing firm defenses
- Discussion of what to expect going forward
- Has geographic market definition been resolved
- Will efficiencies arguments work
Who Should Attend:
- Antitrust Lawyers
- Pharmaceutical and Healthcare Industries
- General Counsel in Life Sciences and Healthcare Industries
- Pharma/Healthcare Attorneys & Advisors
- Pharmaceutical Companies
- Other related/interested Professionals and Organizations
Dr. Weglein consults on cases requiring economic analyses and damages estimates in antitrust, finance and securities, intellectual property, and general business litigation. Dr. Weglein has worked on mergers in the insurance industry, and has provided expert support in antitrust litigation in the health insurance market. In several large antitrust litigations involving alleged anticompetitive conduct by Microsoft, Dr. Weglein analyzed the economics of prepackaged software and managed projects to assess potential damages; he also worked on behalf of Intel in antitrust litigation brought by AMD and by the State of New York. Dr. Weglein has also worked on antitrust litigation in a number of financial markets – financial pricing benchmarks, private equity, and credit default swaps. His experience spans numerous industries, including investment and commercial banking, securities brokerage and clearing, asset management, semiconductors, computer hardware and software, oil and gas, automotives, steel, real estate, medical devices, agribusiness, and biotechnology. Dr. Weglein is also the co-author of two white papers addressing competition issues in the automotive industry.
Dr. Weglein consults on cases requiring economic analyses and damages estimates in antitrust, finance and securities, intellectual property, and general …
William J. Thomashower is a founding partner of Schwartz & Thomashower LLP a New York City litigation boutique serving domestic and international companies from Fortune 100 corporations to small businesses. He has more than 40 years’ litigation experience in both federal and state courts in antitrust, commercial, intellectual property, healthcare, constitutional law, contracts, real property and other matters. He has litigated or advised companies on a wide range of subjects including antitrust, and intellectual property encompassing patents, trademarks and copyrights. He has acted as lead counsel in several significant healthcare and healthcare antitrust cases representing physicians, provider groups and healthcare facility developers. He is an honors graduate of Columbia Law School and serves on bar association committees for the ABA, NYSBA, and NYIPLA.
William J. Thomashower is a founding partner of Schwartz & Thomashower LLP a New York City litigation boutique serving domestic …
Fred Isquith is a senior partner at Wolf Haldenstein and Chair of the Antitrust/Competition Law practice. Mr. Isquith has extensive experience in antitrust law and securities law and has been at the forefront of several notable federal class actions.
Mr. Isquith has extensive experience in complex class actions including representation of institutional investors. Mr. Isquith joined the firm in 1980 as a partner.
For more than 25 years, Mr. Isquith has authored and published commentary on noteworthy federal class action and complex litigation and the judiciary including more than 50 articles, 1000 columns and a chapter in a book regarding Federal Civil Practice. He is also cited by legal industry media as a resource on complex litigation.
Fred Isquith is a senior partner at Wolf Haldenstein and Chair of the Antitrust/Competition Law practice. Mr. Isquith has extensive …
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About Analysis Group
Analysis Group is one of the largest private economics consulting firms in North America, with more than 700 professionals across 11 offices in the United States, Canada, and China. Since 1981, the firm has provided expertise in economics, finance, healthcare analytics, and strategy to top law firms, Fortune 500 companies, and government agencies. Analysis Group’s internal experts, together with its network of affiliated experts from academia, industry, and government, offer its clients exceptional depth of expertise.
About Schwartz & Thomashower LLP
Schwartz & Thomashower LLP represents clients in complex commercial, antitrust, employment and intellectual property transactions and disputes. We counsel and represent a wide array of domestic and international companies and individuals, from Fortune 100 corporations to businesses just starting out and individuals involved in personally significant transactions and disputes. Every member of our team is a skilled practitioner, with a well of experience in all aspects of our practice, from negotiating deals to trying cases. Our clients rely on our legal expertise and business acumen to help them develop innovative and effective solutions and to employ thoughtful litigation strategies in collaboration with them to meet their needs. Our clients trust us with their legal and business matters because they know we take the time to understand their business, work closely with them, and handle the matter efficiently.
About Wolf Haldenstein Adler Freeman & Herz LLP
Wolf Haldenstein Adler Freeman & Herz LLP (“Wolf Haldenstein” or the “Firm”) is proud of its long and successful history and more than 125 years. With offices in New York, San Diego and Chicago, the Firm specializes in complex federal and state litigation particularly in the prosecution of complex class actions. In 2016, the National Law Journal named Wolf Haldenstein as one of the top twelve plaintiffs’ firms in the nation and lauded the Firm for its “Exemplary Cutting Edge Work…” Year after year, Wolf Haldenstein’s lawyers are selected as Super Lawyers among their peers. Then just in 2016 alone, the Firm’s lawyers have also been referred to as the “Titan of the Plaintiffs’ Bar” by Law 360, received the “Trailblazer” award from the National Law Journal and identified by Martindale-Hubbard as the nation’s top rated lawyers. As a leader in plaintiffs’ contingency-based litigation, Wolf Haldenstein has recouped over seven billion dollars ($7 billion).