News
DOJ Unveils Task Force on Healthcare Monopolies
Photo: Matt Mawson/Getty Images
The U.S. Department of Justice announced the formation of the Antitrust Division’s Healthcare Monopolies and Collusion (HCMC) Task Force, which will guide the division’s enforcement strategy and policy approach in healthcare.
This will include facilitating policy advocacy, investigations and, where warranted, civil and criminal enforcement in healthcare markets.
“Every year, Americans spend billions of dollars on health care, money that is increasingly gobbled up by a small number of dominant payers, providers and middlemen who have cemented their path to power in communities across the country,” said Assistant Attorney General Jonathan Kanter. of the Department of Justice’s Antitrust Division.
The task force aims to identify and eradicate monopolies, as well as any collusive practices that increase costs and decrease quality, according to the DOJ.
WHAT IS THE IMPACT
HCMC will consider widespread competition concerns shared by patients, healthcare professionals, businesses, and entrepreneurs, including issues related to payer-provider consolidation, serial acquisitions, workforce and quality of care, medical billing, health IT services, and access and misuse of health data. .
The task force will also bring together civil and criminal prosecutors, economists, health sector experts, technologists, data scientists, investigators and political consultants from across the division’s civil, criminal, litigation and political programs, and the Expert Analysis Group to identify and address urgent issues. antitrust problems in healthcare markets.
HCMC will be led by Katrina Rouse, a longtime antitrust prosecutor who joined the Antitrust Division in 2011. Previously, she served as chief of the division’s Defense, Industries and Aerospace Section, assistant chief of the division’s San Francisco office, and special assistant U.S. attorney and defense attorney in the division’s Health Care and Consumer Products Section.
Rouse is a graduate of Columbia University and Stanford Law School, and has clerked for federal judges on the U.S. District Court for the District of Maryland and the U.S. Court of Appeals for the Fifth Circuit. She will also serve as the division’s deputy director of civil enforcement and special health advisor.
The Antitrust Division said it welcomes input from the public, including professionals, patients, researchers, businesspeople and others who have a direct view of competition concerns in the healthcare industry.
When appropriate, the division will refer matters to other federal and state authorities, the DOJ said.
Members of the public can share their experiences with the task force by visiting HealthyCompetition.gov.
THE BIGGEST TREND
Healthcare monopolies, which may be encouraged by hospital consolidation, could have an impact harmful effect on consumer premiums and out of pocket expenses due to resulting outpatient facility fees, a 2023 report concluded.
Consumer advocates, payers, and state regulators have flagged a number of issues related to outpatient facility fees. Both consumer advocates and regulators have expressed concerns about ease of financial exposure rates created for consumers through increased out-of-pocket spending – driven by high-deductible plans and other benefit design features that increase patients’ exposure to sharing. costs – and higher premiums resulting from increased spending on outpatient services.
Jeff Lagasse is editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Publication in the media.