TL/DR –
The U.S. Department of Justice (DOJ) has announced a new task force, the Task Force on Health Care Monopolies and Collusion (HCMC), to address anti-competitive practices in healthcare markets. The HCMC will consist of a multidisciplinary team from the DOJ’s Antitrust Division and will focus on problems like payer-provider consolidation, misuse of healthcare data and many others. While the HCMC is a DOJ initiative, recent collaborations with the Federal Trade Commission and Health and Human Services, among other institutions, suggest that the task force will operate within a broader spectrum of government cooperation and coordination.
US DOJ’s New Task Force to Tackle Antitrust Issues in Healthcare
The US Department of Justice’s Antitrust Division (DOJ) has recently revealed the Task Force on Health Care Monopolies and Collusion (HCMC). This new initiative is aimed at addressing pressing antitrust issues in health care markets including issues regarding payer-provider consolidation, serial acquisitions, medical billing, health care IT services, and misuse of health data. The task force is comprised of professionals across multiple disciplines including law, economics, data science, technology, healthcare industry, and policy.
DOJ’s History of Health Care Task Forces
The DOJ is known for launching task forces to target enforcement priorities. In the health care sector, task forces such as the COVID-19 Fraud Strike Force Teams, the New England Prescription Opioid Strike Force, and the Health Care Fraud Prevention and Enforcement Action Team have been active. However, the effectiveness and success of such task forces vary.
Regulatory Changes in Healthcare Industry
In recent years, federal agencies including the Office of the Inspector General (OIG) and the Centers for Medicare and Medicaid Services (CMS) have collaborated for the Regulatory Sprint to Coordinated Care. Their aim is to remove regulatory barriers and speed up the transformation of the health care system toward value-based care. CMS is also launching a new primary care model in July 2024 to support care integration. However, these changes may pose complexities for healthcare companies in terms of regulatory compliance and enforcement.
State-level Antitrust Oversight and Regulation
Concerns over anticompetitive activities are not limited to the federal government. States like California, Connecticut, and Massachusetts have demonstrated increased interest in antitrust oversight and regulation. For instance, California’s new Office of Health Care Affordability will monitor economic activity in health care and conduct pre-closing reviews of market transactions. Connecticut and Massachusetts have also implemented measures to prevent anticompetitive consolidation in health care.
Potential Changes in Regulatory Landscape
Healthcare entities must keep abreast of the regulatory landscape not only on the federal level, but also on a state level. For instance, California, the world’s fifth largest economy, must be considered by any healthcare entity operating nationwide. Furthermore, with the upcoming 2024 Presidential election, the longevity of the HCMC may not be certain as changes in federal leadership could mean a shift in priorities within the DOJ.
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