Health Care Antitrust and Trade Regulation

We have been among the nation’s preeminent health care antitrust lawyers in the United States for many years. In an era of heightened antitrust scrutiny in the health care sector, our depth of expertise helps our clients navigate the fast-evolving antitrust enforcement landscape.

We regularly represent hospitals, networks, physician practices, pharmaceutical companies, and medical device companies in litigation, counseling, and representation before antitrust enforcers, including the Federal Trade Commission (FTC), U.S. Department of Justice (DOJ), and state enforcement agencies.

Our efforts have included one of the leading hospital merger cases, one of the leading cases in Health Maintenance Organization (HMO) antitrust liability, and one of the few cases in which a government enforcer’s merger challenge was defeated on a motion for summary judgment.

Our team includes some of the leading commentators on health care antitrust issues, including the current chair of the American Health Law Association’s (AHLA) Antitrust Practice Group.

We also defend antitrust investigations and litigation matters involving information exchanges, physician acquisitions, and health plan transactions.

Defense of Hospital Mergers and Physician Group Acquisitions

Our team has extensive experience securing antitrust approval for hospital mergers and physician group acquisitions, including many involving in-market competitors. Working closely with Honigman’s Health Care Practice Group, we have won approval for dozens of transactions at both the state and federal level. We have defended government investigations of hospitals, physician practices, and hospital networks in Florida, Idaho, Indiana, Iowa, Michigan, Missouri, Pennsylvania, and Washington. We also have significant experience navigating the growing web of state premerger notification statutes which apply to many hospital and physician group transactions. We have counseled numerous hospitals and physician groups regarding mergers and acquisitions in Alabama, Arizona, California, Connecticut, Florida, Idaho, Indiana, Iowa, Kentucky, Maine, Maryland, Massachusetts, Michigan, Mississippi, Nebraska, New Jersey, New York, Oklahoma, Pennsylvania, South Carolina, and Texas.

Private Equity Investment in Health Care

Honigman’s antitrust team regularly advises some of the nation’s leading private equity firms on investment in health care companies. We advise on antitrust considerations associated with “roll up” acquisition strategies, minority investments, and the post-closing operation of acquired portfolio companies. Our practice benefits from Honigman’s extraordinary Private Equity Practice Group comprised of 60+ lawyers devoted to meeting the unique needs of private equity sponsors in the financing, acquisition, operation, and ultimate disposition of their portfolio investments.

Structuring Provider Joint Ventures, including Clinically Integrated Networks

Honigman’s health care antitrust attorneys regularly advise clients on the creation and operation of provider joint ventures, including clinically integrated networks. Our clients have included some of the largest clinically integrated networks in the country by physician count. We help clients ensure that their joint ventures have sufficient clinical and/or financial integration, and have appropriate safeguards in place to address evolving antitrust risks. We have counseled physician and hospital networks in Alabama, Arizona, California, Iowa, Kentucky, Michigan, Mississippi, Nebraska, Tennessee, and Texas.

Hospital Antitrust Litigation

We have decades of experience representing hospitals, in connection with antitrust claims involving: M&A transactions alleged to violate the antitrust laws, price fixing conspiracies, most-favored-nation pricing, exclusionary conduct, monopolization, information exchanges, and other antitrust issues. These cases have included several antitrust challenges to hospital monopolies and dominant hospital systems.

Our experience includes the following:

• Saint Francis Hospital and Medical Center, Inc. v. Hartford HealthCare Corporation, et al. Challenge to physician practice acquisitions and other anticompetitive actions by a hospital monopoly.
• St. Luke’s Hospital, et al. v. ProMedica Health System, Inc., et al.  Antitrust challenge to dominant hospital system.
• Saint Alphonsus v. St. Luke's Health System, Ltd. Antitrust challenge to dominant hospital systems’ acquisition of physician practice.
• BRFHH Shreveport v. Willis-Knighton. Antitrust challenges to monopoly hospital.
• State of Washington v. Franciscan Health System, et al. Defeat of a state enforcer’s merger challenge in a hospital system’s physician group acquisition on a motion for summary judgment; the eventual settlement required no divestitures of physicians.
• U.S. v. Mercy Health Services. Successful defense of a hospital merger against a Justice Department challenge
• Advocacy Organization for Patients and Providers v. Mercy Health Services. Successful defense of hospital merger.
• Williams v. Kleaveland. Defense of conspiracy claim relating to loss of medical staff privileges.
• Beyer v. Bronson Methodist Hospital. Defense of physician staff privileges claim.
• Sarin v. Samaritan Health Center. Defense of physician staff privileges claim.
• Ezpeleta v. Sisters of Mercy Health Corp. Defense of exclusive physician contract case.
• Mid-Michigan Radiology Associates v. Central Michigan Community Hospital. Exclusive radiology contract case.
• Chi v. Sisters of Mercy Health Corporation. Defense of preliminary injunction against exclusive physician contract.
• Modi v. Port Huron Hospital. Defense of claim relating to exclusive physician contracts.
• Patel v Northern Arizona Healthcare. Defense of claims that hospital system attempted to monopolize cardiology services.
• Calabrese v. St. Mary's. Defense of antitrust claims relating to physician exclusion.
• Cason-Merendo v. Detroit Medical Center. Defense of class action alleging hospital conspiracy to suppress nurses' wages.
• Heartland Surgical Specialty Hospital, LLC v. Midwest Division, Inc. Defense of claim of boycott of physician-owned specialty hospital.
• PC Healthcare Enterprises, Inc. v. Arizona Hospital and Healthcare Association. Claim of fixing of per diem nurses' wages by hospitals.
• Doe v. Arizona Hospital & Health Care Association. Putative class action alleging price fixing by hospitals in the purchase of per diem nurse and traveler nurse services.
• Health Alliance Plan of Michigan v. Blue Cross Blue Shield of Michigan Mutual Insurance Company. Claim arising out of most favored nations clauses. 
• Glen Eden Hospital v. Blue Cross Blue Shield. Defense of price-fixing claim against Blue Cross plan and hospital association.

Many of these cases involved representing plaintiffs in challenges to a hospital monopoly and/or anticompetitive conduct by a dominant hospital. See also Plaintiff's Antitrust Litigation and Plaintiffs’ Private Health Care Antitrust Actions.

Antitrust Challenges to Physician Noncompetes

We have taken the lead in using the antitrust laws to challenge physician noncompetes. Our cases include: 

• Holy Cross Hospital, Inc. v. American Anesthesiology Services of Florida, Inc., et al. Antitrust challenge to noncompete and nonsolicitation clauses.
• St. Joseph’s Hospital Health Center v. American Anesthesiology of Syracuse, P.C., et al. Antitrust challenge to noncompete and nonsolicitation clauses.
• Trinity Health Corporation v. Anesthesia Associates of Ann Arbor, PLLC. Antitrust challenge to noncompete clauses covering hospital-based physicians at 6 hospitals.

Other Health Care Antitrust Cases

We have also defended hospitals, physician groups, pharmaceutical companies, and other health care entities in numerous cases, including the following:

• Mylan v. Warner Chilcott. Successful defense of a branded pharmaceutical company against “product hopping” antitrust claims; summary judgement granted for the defendants and upheld in the Third Circuit.
• Hassan v. Independent Practice Associates. A leading case on HMO and network antitrust liability.
• Health First, Inc. v. Bronson Methodist Hospital. Antitrust issues involving HMO.
• U.S. v. Federation of Certified Surgeons and Specialists. Defense of Department of Justice investigation and negotiation of a consent agreement on behalf of a Florida network of general surgeons.
• In the Matter of Texas Surgeons, P.A. Defense of an antitrust investigation by the Federal Trade Commission (FTC) and Texas Attorney General and negotiation of a consent decree on behalf of an Austin, Texas, network of general surgeons.
• D&M Orthotics and Prosthetics v. Sisters of Mercy Health Corp. Defense of claim of exclusion of provider.
• Associated Foot Surgeons v. National Foot Care Program, Inc. Defense of boycott claim against PPO.
• Commonwealth of Pennsylvania v. Urology of Central Pennsylvania, Inc. Defense of physician merger and negotiation of consent order.