Health Care markets are replete with antitrust issues. For decades, Ropes & Gray’s antitrust lawyers have played a central role in the health care system's evolution. We have facilitated the formation of hospital networks and organizations, assisted with the formation of physician and physician hospital organizations, and guided dozens of hospitals through the merger review process at the state and federal levels. Ropes & Gray lawyers have also secured favorable business review letters from federal and state agencies regarding joint ventures and affiliations, and defended nearly every type of provider in state and federal investigations. Our litigators successfully represent our health care clients in a wide variety of antitrust litigations.

Tight collaboration with Ropes & Gray's nationally recognized health care practice plays a key role in our success. Our antitrust lawyers are deeply familiar with how health care markets operate. Demonstrating our understanding of the industry, our antitrust lawyers represent hospitals in many disputes – both antitrust and non-antitrust related - before state and federal agencies and in state and federal courts. Ropes & Gray antitrust lawyers have editorial positions at health care antitrust publications and have written a number of journal articles and papers regarding health care antitrust issues. We are also significantly involved with health care antitrust committees and organizations.

Ropes & Gray lawyers handle all types of health care antitrust matters:

Government Investigations. Ropes & Gray has a proven track record of responding to government inquiries and investigations quickly, comprehensively, and efficiently. Our lawyers practice regularly before the FTC and DOJ and have responded to dozens of subpoenas over the years. This experience, combined with our efficient ability to respond to information requests, ensures that government investigations do not unnecessarily burden our clients.

Joint Ventures. Ropes & Gray antitrust lawyers advise clients on the size, formation, pricing, integration, and exclusive arrangements associated with health care joint ventures. We have substantial experience with a wide variety of provider-side agreements, including affiliations, “virtual mergers,” and accountable-care organizations. We work closely with the firm’s health care attorneys to reduce risks that joint ventures run afoul of antitrust pitfalls, whether the collaborations involve group purchasing or joint contracting and clinical integration. We have also designed comprehensive clinical and financial integration programs for large physician networks, including messenger models.

Hospital Mergers. There has been a resurgence of hospital mergers in recent years as hospitals have responded to demands for increased efficiencies and lower costs from government and private payors alike. Our team of FTC and DOJ veterans has extensive experience in guiding hospital mergers to successful completion. The Ropes & Gray antitrust group combines deep substantive knowledge with a keen understanding of the merger review process. Our team includes a pre-merger notification group renowned for its mastery of the Hart-Scott-Rodino Act’s complex filing requirements, which is especially relevant for hospital mergers involving non-profit institutions.

Physician Hospital Organizations. The changing economics of the health care industry has encouraged hospitals and physicians to form new organizations and expand the size and geographic scope of existing physician organizations or physician hospital organizations. Our antitrust group provides expert advice on the formation and operation of these organizations – including Accountable Care Organizations (ACOs) – and has significant experience in representing such organizations in the context of state and federal investigations.

Counseling & Compliance. We routinely advise health care providers on antitrust issues, including those associated with managed care contracting and pricing, and physician staffing. We have also devised compliance programs for large physician groups and health care systems, tailoring each program to meet the client’s specific needs and issues.

Health Care Antitrust Litigation. We have significant experience representing hospitals and health care systems in connection with antitrust claims involving, among others, price fixing conspiracies, most favored nation pricing, exclusionary conduct, monopolization, closed staffing models, and other physician issues.

REPRESENTATIVE MATTERS

Government Investigations

• Representation of multiple hospitals and providers in connection with civil investigative demands issued by a state attorney general’s office in connection with regulatory proceedings regarding cost drivers and increased health care costs in the state.
   
• Representation of a large group of specialty physicians in connection with an FTC investigation of alleged anticompetitive conduct.
   
• Representation of physician practices in connection with the sale of medical devices and equipment to hospitals, providers, and group purchasing organizations.
   
• Representation of an integrated physician group in connection with an FTC investigation of the group’s joint managed care contracting practices.
   
• Representation of a health insurer in connection with a DOJ investigation of provider and payor contracting practices.

Joint Ventures and Mergers

• Representation of Welsh, Carson, Anderson & Stowe and its portfolio company, Viant, Inc., before the Antitrust Division in the successful clearance of the combination of Viant and MultiPlan, Inc., the two leading nationwide independent PPO networks.
   
• Obtained DOJ clearance for a consortium of hospitals, health plans, and employers to share health service data in a project developing cost and quality measures.
   
• Representation of hospitals and hospital systems in FTC and state attorneys general review of merger and affiliation agreements; representations include obtaining state Department of Public Health approvals.
   
• Representation of parties in numerous hospital mergers, including, among others, mergers involving non-profit hospitals, academic medical centers, and for-profit hospitals.
   
• Representation of academic medical centers and community hospitals in connection with joint research and medical services in various contexts.

Counseling and Compliance

• Representation of health care systems in connection with the formation of accountable care organizations and other types of physician hospital organizations (“PHOs”).
   
• Representation of hospitals and hospital systems in connection with payor contracting and joint contracting issues, including the use of most favored nation pricing clauses and the use of the messenger model to convey payor proposals to physicians and physician groups.
   
• Representation of hospital systems concerning staff privileges and peer review committees and representation of hospitals in connection with peer review proceedings and corrective action cases.
   
• Representation of hospitals and physician groups in connection with open and closed physician staffing models, coordination of physician on-call coverage, physician group affiliations, and formation of independent physician associations (“IPAs”).
   
• Representation of health care providers in connection with creating an antitrust compliance program.
   
• Representation of health care providers and medical professional societies on the antitrust implications of standard-setting and advocacy related to commercial payor contracts.
   
• Representation of state universities and hospitals with respect to Noerr-Pennington and state action immunity issues in connection with Medicaid reimbursement efforts.
   
• Representation of hospitals and hospital systems on practices and procedures in connection with referrals to hospital-owned physician practices.

Health Care Related Antitrust Litigation

• Fox v. Good Samaritan Hospital L.P. (N.D. Cal.; 9th Cir.). Lead counsel in obtaining successful summary judgment of claims that the hospital unlawfully monopolized by denying provider privileges.
   
• Johnson v. Arizona Hospital and Healthcare Association (D. Ariz.). Lead counsel on behalf of for-profit hospitals in connection with alleged trade association activity designed to suppress wages for temporary nursing services.
   
• HealthSouth Corporation v. SNH (Mass Super. Ct.). Lead counsel at successful trial of case involving default, transfer, and ownership in connection with two HealthSouth rehabilitation hospitals.
   
• Deutsch v. William W. Backus Hospital (Conn. Super. Ct.). Lead counsel in action arising out of peer review proceeding.
   
• Five Star Quality Care, Inc. v. Sunrise Senior Living (Mass. Super. Ct.). Lead counsel for health care services company in connection with claims against manager of senior living communities.
   
• Amgen v. F. Hoffman La-Roche (D. Mass.; Fed. Cir.). Lead antitrust counsel for pharmaceutical company challenging alleged monopolization of anemia drug marketed by rival.
  
  
  

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