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Working with Competitors

Learn about the antitrust implications of provider networks.

Transcript

In healthcare, multiple healthcare providers frequently form groups or networks with similar or related providers. These networks can create efficiencies that improve patient care and lower healthcare costs.

But anytime that competitors group together, antitrust laws become a concern. Let’s explore how the antitrust laws try to balance the potential benefits and harms that come with provider networks.

I. Provider-Controlled Networks

We’ll start with provider-controlled networks. A...

Lessons

1. Welcome
  • Welcome to Healthcare Law
2. Health Insurance
  • Medicare
  • Medicaid
  • Private Rights Enforcement
  • ERISA
  • ERISA Preemption and Remedies
  • ERISA Remedies and ACA Reforms
3. The Structure of Healthcare Entities
  • The Professional Workforce
  • Forming a Healthcare Entity
  • Fiduciary Duties at Healthcare Entities
  • Tax-Exempt Status
  • Joint Ventures and Tax-Exempt Status
4. Fraud and Abuse in Healthcare
  • The False Claims Act
  • The Anti-Kickback Statute
  • Stark Law
  • Enforcement Mechanisms
  • Qui Tam Actions
5. Antitrust Issues in Healthcare
  • Overview of Antitrust Laws in Healthcare
  • Mergers and Acquisitions in Healthcare
  • Working with Competitors
  • Payers with Market Power
6. Tort Liability of Healthcare Entities
  • The Physician-Patient Relationship
  • Physician Duties Regarding Information
  • Physician Duties Regarding Clinical Care
  • Hospital and Health Plan Liability
7. Recurring Legal Issues in Patient Care
  • Reproduction and Birth
  • Organ Transplantation
  • Research Involving Human Subjects
  • The End of Life
  • Health Privacy
  • Discrimination in Healthcare
8. Public Health Law
  • The Police Power
  • Free Exercise Challenges
  • Noncommunicable Conditions