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Simple Health Plans LLC

On Oct. 29, 2018, the Federal Trade Commission filed a complaint in federal court against Simple Health Plans LLC, Steven J. Dorfman, and five other entities, alleging that the defendants misled people to think they were buying comprehensive health insurance that would cover preexisting medical conditions, prescription drugs, primary and specialty care treatment, inpatient and emergency hospital care, surgical procedures, and medical and laboratory testing. On Nov. 1, 2019, the FTC filed an amended complaint adding Candida Girouard as an additional defendant.  

Type of Action
Federal
Last Updated
FTC Matter/File Number
172 3148

Sanford Health/Sanford Bismarck/Mid Dakota Clinic, In the Matter of

The FTC issued an administrative complaint and authorized a federal court action to block Sanford Health's proposed acquisition of Mid Dakota Clinic, alleging that the deal would vioated antitrust law by significantly reducing competition for adult primary care physician services, pediatric services, obstetrics and gynecology services, and general surgery physician services in the greater Bismarck and Mandan metropolitan area. The FTC, jointly with the Office of the Attorney General of North Dakota, filed a complaint in federal district court seeking a temporary restraining order and preliminary injunction to stop the deal and maintain the status quo pending an administrative trial on the merits. According to the complaint, Sanford and Mid Dakota are each other's closest rivals in the four-county Bismarck-Mandan region of North Dakota, and the merger would create a group of physicians with at least 75 to 85 percent share in the provision of adult primary care physician services, pediatric services, obstetrics and gynecology services. On July 9, 2019, after Sanford abandoned its acquisition of Mid Dakota Clinic, the Commission announced that it voted 5-0 to dismiss the case.

Type of Action
Administrative
Last Updated
FTC Matter/File Number
171 0019
Docket Number
9376
Case Status
Closed

Surescripts LLC

The FTC sued the health information company Surescripts, alleging that the company employed illegal vertical and horizontal restraints in order to maintain its monopolies over two electronic prescribing, or “e-prescribing,” markets: routing and eligibility.  According to the complaint, Surescripts monopolized two separate markets for e-prescription services: The market for routing e-prescriptions, which uses technology that enables health care providers to send electronic prescriptions directly to pharmacies; and the market for determining eligibility, a separate service that enables health care providers to electronically determine patients’ eligibility for prescription coverage through access to insurance coverage and benefits information, usually through a pharmacy benefit manager.The FTC alleges that Surescripts intentionally set out to keep e-prescription routing and eligibility customers on both sides of each market from using additional platforms (a practice known as multihoming) using anticompetitive exclusivity agreements, threats, and other exclusionary tactics. Among other things, the FTC alleges that Surescripts took steps to increase the costs of routing and eligibility multihoming through loyalty and exclusivity contracts.

Type of Action
Federal
Last Updated
FTC Matter/File Number
141 0210