Medicine claims another victory in insurance mega-mergers

Friday, April 28, 2017 01:52 PM
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Landmark ruling upheld, protects U.S. patients and physicians

Today Anthem suffered another setback in its determined push to overcome a district court ruling and a break-up lawsuit by its future-ex-acquisition, Cigna, when the U.S. Court of Appeals for the District of Columbia upheld a lower court’s tough-worded ruling against Anthem that blocked their proposed $54 billion mega insurance merger.

The opinion aligned closely with the federal district court’s finding that the merger acquisition was anti-competitive and agreed with the Department of Justice’s argument—supported by the American Medical Association, Colorado Medical Society and 16 other state medical associations where these mergers would have been most harmful, as well as Colorado Attorney General Cynthia Coffman and several other state attorneys general—that the acquisition would, like its predecessors, suppress the clinical authority of physicians; raise, not lower, premiums; and grant impermissible market concentrations that would invite abuse and unaccountability. In short, Anthem would have both monopolistic and monopsonistic powers over those markets, physicians, their patients and other caregivers and institutions.

It is not yet known if Anthem will persist and petition the U.S. Supreme Court, but Anthem to date has vigorously fought Cigna’s lawsuit to bail out of the merger-acquisition and has moved to flank the courts politically, giving generously to the presidential inaugural activities, publicly endorsing a number of aspects of the White House-backed “repeal and replace” of the Affordable Care Act, and has seen one of their top antitrust lawyers moved to head the Antitrust Division of the Department of Justice.

“We must remain steadfast in our resolve to block Anthem’s power play,” said CMS President Katie Lozano, MD, FACR. “We are deeply grateful for the talent and resources brought to bear in this legal challenge by the AMA’s expert team, our very own Attorney General Coffman, and our colleagues in the most affected states.”

Click here to read more from the AMA.

Posted in: ASAP | Practice Evolution | Payment Reform | Interacting With Payers | Initiatives | Advocacy | AMA


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