The Department of Justice (DOJ) has established a new task force, the Health Care Monopolies and Collusion (HCMC), within its Antitrust Division to address potential issues arising from health care market monopolies and collusion. According to Jeff Baird, chairman of the Health Care Group at Brown & Fortunato, this move is necessary as concerns about vertical integration have been growing in the health care industry.
The focus on this task force is warranted due to the dominance of a few pharmacy benefit managers (PBMs) in the pharmacy space, which own mail-order pharmacies (MOPs) that compete with independent MOPs. The PBMs limit the number of independent MOPs on their panels and steer patients towards their own MOPs. This trend could potentially impact the Home Medical Equipment (HME) industry, as insurance companies that own plans may also move into the DME space, creating competition issues for independent DME suppliers.
The task force appears to be action-oriented, with a goal of civil and criminal enforcement in health care markets. While criminal cases will be brought only in extreme circumstances, there is a potential for a proliferation of civil cases. The task force will provide a roadmap for the DOJ and Federal Trade Commission (FTC) to scrutinize mergers and acquisitions in the health care industry, potentially leading to enforcement actions against transactions that violate antitrust laws.
For HME providers, the establishment of this task force could have implications. While acquisitions in the DME space may not lead to monopolization issues, vertical integration by large insurers purchasing DME suppliers or forming their own DME businesses could create competition issues for independent DME suppliers, similar to the predicament faced by independent pharmacies dealing with PBMs. It is essential for HME providers to stay informed about the activities of the HCMC task force and any potential impact on their industry.
