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Sarasota, FL (WorkersCompensation.com) – This year has certainly been an interesting year for healthcare.
In March, the Biden administration announced their intent to further investigate private equity ownership and relationships in healthcare. Part of the initiative was driven by multiple studies clearly suggesting a correlation between increase in costs and adverse events with acquisitions and mergers.
Earlier this week, the Department of Justice (DOJ) officially announced the formation of the new investigative arm, Antitrust Division’s Task Force on Health Care Monopolies and Collusion (HCMC). Antitrust prosecutor, Katrina Rouse, who joined the Antitrust Division in 2011, has been appointed director.
The purpose of the HCMC will be to develop a strategy and protocol for the division, and facilitate investigations as well as civil and criminal enforcements when necessary as related to the healthcare market. With a focus on competition in healthcare, the HCMC will review concerns as reported by providers, patients, and business associates. The task force has created a website for the purpose of gathering complaints as related to fair competition in healthcare.
Some of the issues being reviewed by the task force will include payer-provider consolidation and serial acquisitions, labor as related to quality of care, provider billing, healthcare IT services, and healthcare data that may be accessed or misused. The DOJ states that in their efforts to develop the program, they are utilizing experts from the healthcare industry, prosecutors, IT experts, data scientists, and multiple advisors from Civil, Criminal, Litigation and Policy Programs, and the Expert Analysis Group in their effort to prioritize antitrust issues to review.
Jonathan Kanter, Assistant Attorney General of the Justice Department’s Antitrust Division believes that a small number of healthcare entities have leveraged an unfair amount of power through consolidation. Kanter believes the new task force will address these concerns stating, “Led by Katrina Rouse, the task force will identify and root out monopolies and collusive practices that increase costs, decrease quality and create single points of failure in the health care industry.”
What is interesting about this new focus in the Biden administration, is that in the midst of a data breach of historical proportions, it was somewhat quietly announced that the DOJ had initiated an antitrust investigation into UnitedHealth about its relationship between its insurance unit and health-services arm. According to an April Beckers report, UnitedHealth executives sold $101.5 million in stock starting the week after the company received notice of the investigation. In yet another recent report this week, UnitedHealth Group and Amedisys announced plans to sell more than 100 clinic locations to a private equity buyer.
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About The Author
About The Author
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F.J. Thomas
F.J. Thomas has worked in healthcare business for more than fifteen years in Tennessee. Her experience as a contract appeals analyst has given her an intimate grasp of the inner workings of both the provider and insurance world. Knowing first hand that the industry is constantly changing, she strives to find resources and information you can use.
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