DOJ targets health care monopolies, collusion 

WASHINGTON – The U.S. Department of Justice has formed a Task Force on Health Care Monopolies and Collusion (HCMC) within its Antitrust Division to guide its enforcement strategy and policy approach, including by facilitating advocacy, investigations and, where warranted, civil and criminal enforcement in health care markets. 

“Every year, Americans spend trillions of dollars on health care, money that is increasingly being gobbled up by a small number of payers, providers and dominant intermediaries that have consolidated their way to power in communities across the country,” said Assistant Attorney General Jonathan Kanter of the DOJ’s Antitrust Division. “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.” 

HCMC’s mission 

The HCMC will consider widespread competition concerns shared by patients, health care professionals, businesses and entrepreneurs, including issues regarding payer-provider consolidation, serial acquisitions, labor and quality of care, medical billing, health care IT services, access to and misuse of health care data and more. It will bring together civil and criminal prosecutors, economists, health care industry experts, technologists, data scientists, investigators and policy advisors from across the division’s Civil, Criminal, Litigation and Policy Programs, and the Expert Analysis Group, to identify and address pressing antitrust problems in health care markets. 

Its leader 

The HCMC will be directed by Katrina Rouse, a long-serving antitrust prosecutor who joined the Antitrust Division in 2011. She previously served as chief of the division’s Defense, Industrials and Aerospace Section, assistant chief of the division’s San Francisco Office, a Special Assistant U.S. Attorney and a trial attorney in the division’s Healthcare and Consumer Products Section. 

The industry’s reaction 

“This is a very encouraging development and it’s long overdue,” said B. Douglas Hoey, CEO of the National Community Pharmacists Association. “The PBM/insurance conglomerates are among the most aggressive, ruthless, and predatory corporate actors in the entire economy. The largest corporate pharmacy in the world owns the largest PBM in the world. The other large PBMs are owned by, or entangled with, some of the largest insurance companies in the world. These corporate Frankenstein monsters use their size and leverage to starve community pharmacies by often paying them less than what the pharmacy pays for the medicine and steering community pharmacies’ patients into their own retail pharmacies, or their own mail-order and specialty pharmacies. These anticompetitive business practices are leading to reduced access to care for patients and higher prescription costs.” 

The Antitrust Division welcomes input and information from the public, including from practitioners, patients, researchers, business owners and others who have direct insight into competition concerns in the health care industry. Members of the public can share their experiences with HCMC by visiting HealthyCompetition.gov.