Health care antitrust

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Veröffentlicht: Gaithersburg, Md. Aspen Publishers 1998
Schriftenreihe:Aspen Health Law Center current issues
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adam_text TABLE OF CONTENTS PREFACE. . ..................IX INTRODUCTION 1 OVERVIEW: FEDERAL ANTITRUST STATUTES 1 THE SHERMAN ACT .....2 THE CLAYTON ACT .2 THE FEDERAL TRADE COMMISSION ACT ......3 APPLICATION OF ANTITRUST STATUTES TO HEALTHCARE ...3 ANTITRUST ENFORCEMENT ...........................4 DEPARTMENT OF JUSTICE ...5 FEDERAL TRADE COMMISSION .6 STATE ATTORNEYS GENERAL .7 PRIVATE ENFORCEMENT .........8 FUNDAMENTAL ANTITRUST PRINCIPLES.... .........9 INTERSTATE COMMERCE REQUIREMENT .10 STANDARDS OF LEGALITY ..10 PER SE RULE 11 RULE OF REASON 13 DEFINITION OF CONCERTED ACTION .......14 PROOF OF CONCERTED ACTIVITIES .....15 ESTABLISHING UNREASONABLE RESTRAINT OF TRADE .......15 MARKET POWER .16 PRODUCT MARKET .......17 GEOGRAPHIC MARKET .......20 VI HEALTH CARE ANTITRUST EVALUATING MARKET POWER IN THE RELEVANT MARKET ....22 MONOPOLIES 23 MONOPOLIZATION ...23 MONOPOLY LEVERAGING 25 ESSENTIAL FACILITIES 27 PREDATORY PRICING 28 MONOPSONY POWER 29 EXEMPTIONS ...29 FEDERAL IMMUNITY: IMPLIED REPEAL .30 STATE ACTION IMMUNITY ....31 ACTIONS TAKEN BY STATE AGENCIES 31 ACTIONS TAKEN PURSUANT TO STATE LAW 32 PEER REVIEW ACTIVITIES 34 STATE STATUTES: HOSPITAL COLLABORATIVE VENTURES 36 ACTIONS TAKEN PURSUANT TO LOCAL GOVERNMENT DIRECTION 38 THE NOERR-PENNINGTON DOCTRINE .39 NONPROFIT INSTITUTIONS 40 BUSINESS OF INSURANCE ..42 HEALTH CARE QUALITY IMPROVEMENT ACT 44 CONTRACTS AND OTHER AGREEMENTS........... ,..47 AGREEMENTS RELATED TO PRICE.. 47 HORIZONTAL AGREEMENTS ON PRICE ...47 HORIZONTAL AGREEMENTS ON PRICE AMONG PURCHASERS 54 VERTICAL AGREEMENTS ON PRICE BETWEEN BUYERS AND SELLERS ...56 MOST-FAVORED-NATION CLAUSES 58 BALANCE BILLING 61 MARKET ALLOCATION 62 GROUP BOYCOTTS OR CONCERTED REFUSALS TO DEAL ,.63 TYING ARRANGEMENTS ....67 EXCLUSIVE AGREEMENTS ......69 JOINT ACTION IN RELATION TO CONTRACT NEGOTIATION ....72 TABLE OF CONTENTS VII APPOINTING A COLLECTIVE BARGAINING AGENT ......72 DATA DISSEMINATION ..............75 SAFETY ZONE FOR PROVISION OF MEDICAL INFORMATION ...........76 SAFETY ZONE FOR PROVISION OF FEE-RELATED INFORMATION ,..,......77 SAFETY ZONE FOR EXCHANGES OF PRICE AND COST INFORMATION 78 MERGERS AND ACQUISITIONS......... ...............................79 HORIZONTAL CONSOLIDATIONS .........80 HOSPITAL MERGERS 81 VERTICAL CONSOLIDATIONS .........90 CONGLOMERATE CONSOLIDATIONS ......91 PRE-MERGER NOTIFICATION PROCESS ............92 DEFENSES ............95 FAILING COMPANY DEFENSE .............95 EFFICIENCY/PROCOMPETITIVE EFFECTS 96 JOINT VENTURES AND PROVIDER NETWORKS........ ..........97 JOINT VENTURES TO PROVIDE SERVICES OR PRODUCTS .........98 ANTITRUST ANALYSIS..... .....98 SAFETY ZONES FOR CERTAIN HOSPITAL JOINT VENTURES ...100 JOINT PURCHASING ARRANGEMENTS 102 JOINT VENTURES WITH HMOS AND OTHER PREPAID PLANS ....103 PREFERRED PROVIDER ORGANIZATIONS ...........106 PROVIDER-CONTROLLED PPOS 106 PAYER-CONTROLLED PPOS ....109 PROVIDER NETWORKS ..109 INTEGRATION DENNED 110 JOINT PRICING AND THE MESSENGER MODEL ...112 PHYSICIAN NETWORK JOINT VENTURES ...........113 MULTIPROVIDER NETWORKS ...........115 PHYSICIAN HOSPITAL ORGANIZATIONS 119 ADDITIONAL AGENCY GUIDANCE 121 INDEX............. ..........................................139
adam_txt TABLE OF CONTENTS PREFACE. . .IX INTRODUCTION 1 OVERVIEW: FEDERAL ANTITRUST STATUTES 1 THE SHERMAN ACT .2 THE CLAYTON ACT .2 THE FEDERAL TRADE COMMISSION ACT .3 APPLICATION OF ANTITRUST STATUTES TO HEALTHCARE .3 ANTITRUST ENFORCEMENT .4 DEPARTMENT OF JUSTICE .5 FEDERAL TRADE COMMISSION .6 STATE ATTORNEYS GENERAL .7 PRIVATE ENFORCEMENT .8 FUNDAMENTAL ANTITRUST PRINCIPLES. .9 INTERSTATE COMMERCE REQUIREMENT .10 STANDARDS OF LEGALITY .10 PER SE RULE 11 RULE OF REASON 13 DEFINITION OF CONCERTED ACTION .14 PROOF OF CONCERTED ACTIVITIES .15 ESTABLISHING UNREASONABLE RESTRAINT OF TRADE .15 MARKET POWER .16 PRODUCT MARKET .17 GEOGRAPHIC MARKET .20 VI HEALTH CARE ANTITRUST EVALUATING MARKET POWER IN THE RELEVANT MARKET .22 MONOPOLIES 23 MONOPOLIZATION .23 MONOPOLY LEVERAGING 25 ESSENTIAL FACILITIES 27 PREDATORY PRICING 28 MONOPSONY POWER 29 EXEMPTIONS .29 FEDERAL IMMUNITY: IMPLIED REPEAL .30 STATE ACTION IMMUNITY .31 ACTIONS TAKEN BY STATE AGENCIES 31 ACTIONS TAKEN PURSUANT TO STATE LAW 32 PEER REVIEW ACTIVITIES 34 STATE STATUTES: HOSPITAL COLLABORATIVE VENTURES 36 ACTIONS TAKEN PURSUANT TO LOCAL GOVERNMENT DIRECTION 38 THE NOERR-PENNINGTON DOCTRINE .39 NONPROFIT INSTITUTIONS 40 BUSINESS OF INSURANCE .42 HEALTH CARE QUALITY IMPROVEMENT ACT 44 CONTRACTS AND OTHER AGREEMENTS. ,.47 AGREEMENTS RELATED TO PRICE. 47 HORIZONTAL AGREEMENTS ON PRICE .47 HORIZONTAL AGREEMENTS ON PRICE AMONG PURCHASERS 54 VERTICAL AGREEMENTS ON PRICE BETWEEN BUYERS AND SELLERS .56 MOST-FAVORED-NATION CLAUSES 58 BALANCE BILLING 61 MARKET ALLOCATION 62 GROUP BOYCOTTS OR CONCERTED REFUSALS TO DEAL ,.63 TYING ARRANGEMENTS .67 EXCLUSIVE AGREEMENTS .69 JOINT ACTION IN RELATION TO CONTRACT NEGOTIATION .72 TABLE OF CONTENTS VII APPOINTING A COLLECTIVE BARGAINING AGENT .72 DATA DISSEMINATION .75 SAFETY ZONE FOR PROVISION OF MEDICAL INFORMATION .76 SAFETY ZONE FOR PROVISION OF FEE-RELATED INFORMATION ,.,.77 SAFETY ZONE FOR EXCHANGES OF PRICE AND COST INFORMATION 78 MERGERS AND ACQUISITIONS. .79 HORIZONTAL CONSOLIDATIONS .80 HOSPITAL MERGERS 81 VERTICAL CONSOLIDATIONS .90 CONGLOMERATE CONSOLIDATIONS .91 PRE-MERGER NOTIFICATION PROCESS .92 DEFENSES .95 FAILING COMPANY DEFENSE .95 EFFICIENCY/PROCOMPETITIVE EFFECTS 96 JOINT VENTURES AND PROVIDER NETWORKS. .97 JOINT VENTURES TO PROVIDE SERVICES OR PRODUCTS .98 ANTITRUST ANALYSIS. .98 SAFETY ZONES FOR CERTAIN HOSPITAL JOINT VENTURES .100 JOINT PURCHASING ARRANGEMENTS 102 JOINT VENTURES WITH HMOS AND OTHER PREPAID PLANS .103 PREFERRED PROVIDER ORGANIZATIONS .106 PROVIDER-CONTROLLED PPOS 106 PAYER-CONTROLLED PPOS .109 PROVIDER NETWORKS .109 INTEGRATION DENNED 110 JOINT PRICING AND THE MESSENGER MODEL .112 PHYSICIAN NETWORK JOINT VENTURES .113 MULTIPROVIDER NETWORKS .115 PHYSICIAN HOSPITAL ORGANIZATIONS 119 ADDITIONAL AGENCY GUIDANCE 121 INDEX. .139
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Gaithersburg, Md. Aspen Publishers 1998
IX, 144 S.
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Aspen Health Law Center current issues
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Antitrust law / United States
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spellingShingle Health care antitrust
Recht
Medical care / Law and legislation / United States
Antitrust law / United States
title Health care antitrust
title_auth Health care antitrust
title_exact_search Health care antitrust
title_exact_search_txtP Health care antitrust
title_full Health care antitrust Aspen Health Law Center
title_fullStr Health care antitrust Aspen Health Law Center
title_full_unstemmed Health care antitrust Aspen Health Law Center
title_short Health care antitrust
title_sort health care antitrust
topic Recht
Medical care / Law and legislation / United States
Antitrust law / United States
topic_facet Recht
Medical care / Law and legislation / United States
Antitrust law / United States
USA
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