Hospital antitrust

Hospital antitrust concerns the many precedents relating to antitrust challenges to hospital monopolization. Leading precedents include the following 18 decisions, of which many were on motions for summary judgment):

Am. Chiropractic v. Trigon Healthcare, 367 F.3d 212, 217-18, 224 (4th Cir. 2004) (the lawsuit asserted "that Trigon and the medical doctors and associations were engaged in a conspiracy that used Trigon's reimbursement policies and treatment guidelines to limit severely the flow of insurance dollars to chiropractors and steer those monies toward medical doctors. Trigon argues that no conspiracy exists, and that it implemented its coverage policies unilaterally based on market supply and demand. The district court agreed with Trigon, dismissing two counts of the complaint for failure to state a claim and disposing of the remaining counts by granting Trigon's motion for summary judgment. Although we apply different reasoning than the district court in some areas, we affirm its disposition of the case in favor of Trigon. ... [M]edical doctors, in their role as members of the peer review committee, had a unity of interest with the hospital: ensuring patient care. We believe that Oksanen's reasoning is not only instructive but persuasive here.").

American Needle v. NFL, 560 U.S. 183 (2010) (Sherman Act ban applies when a conspiracy “joins together independent centers of decision making”)

Austin v. McNamara, 979 F.2d 728 (9th Cir. 1992) (This precedent has been widely followed to exclude evidence of bad faith from lawsuits against hospitals for sham peer review. The Ninth Circuit affirmed a grant of summary judgment to the defendant hospital and doctors affiliated with it.)

BCB Anesthesia Care v. Passavant Memorial Area Hosp. Ass’n, 36 F.3d 664, 669 (7th Cir. 1994) ("Although we hesitate to say that [a staffing decision at one hospital] . . . can never state an antitrust claim, we believe it is incumbent upon the plaintiff to plead some additional facts from which it can be inferred that the case falls within the ambit of the Sherman Act." Seglin v. Esau, supra. [769 F.2d 1274 (7th Cir.1985)] Before we enlist this court in the micromanagement of the staffing arrangements at Passavant under the aegis of the antitrust laws, we need better reasons than the plaintiffs have given us.").

Copperweld Corp. v. Independence Tube Corp., 467 U.S. 752 (1984)

Gabaldoni v. Washington County. Hospital Ass'n, 250 F.3d 255 (4th Cir. 2001) (affirming summary judgment by the district court in a lawsuit challenging a termination of a physician's clinical privileges and denied his application for reappointment to the medical staff, in a lawsuit contract and tort claims against hospital entities; there were no antitrust or Sherman Act claims in this case).

Hein-Muniz v. Aiken Regional Med. Ctrs., 532 Fed. App’x 342 (4th Cir. 2013) (affirming summary judgment against a physician who challenged a hospital's termination of his privileges, but no mention of antitrust or the Sherman Act in this appeal or in district court. Instead the claims were for: breach of contract, breach of contract accompanied by a fraudulent act, violations of the South Carolina and the United States Constitutions and HCQIA, illegality, conspiracy, unfair trade practices, breach of fiduciary duty, and interference with prospective contract. Relief sought included declaratory judgment, actual and compensatory damages, punitive damages, special damages, injunction, and attorney's fees.).

Imperial v. Suburban Hosp. Ass’n, 37 F.3d 1026 (4th Cir. 1994)

Mathews v. Lancaster Gen. Hosp., 87 F.3d 624 (3d Cir. 1996)

Monsanto Co. v. Spray-Rite Serv. Corp., 465 U.S. 752 (1984)

Moore v. Williamsburg Regional Hosp., 560 F.3d 166 (4th Cir. 2009)

Oksanen v. Page Memorial Hosp., 945 F.2d 696 (4th Cir.1991) (en banc)

Poliner v. Tex. Health Sys., 537 F.3d 368 (5th Cir. 2008)

Sugarbaker v. SSM Health Care, 190 F.3d 905 (8th Cir. 1999)

Torbett v. Wheeling Dollar Sav. & Tr. Co., 314 S.E.2d 166 (W. Va. 1983)

Tshibaka v. Sernulka, 673 Fed. App’x. 272 (4th Cir. 2016) (hospital “[i]mmunity applies unless—viewing the totality of the circumstances in an objectively reasonable manner—the aggrieved physician rebuts the presumption that the professional review action satisfied HCQIA.” The Fourth Circuit thereby affirmed a district court grant of summary judgment to the hospital and its CEO, while remanding in favor of plaintiff's claim for defamation).

Wahi v. Charleston Area Med. Ctr., 562 F.3d 599, 601 (4th Cir. 2009) ("The district court concluded most of Wahi's claims were barred because CAMC qualified for immunity from suit under the Health Care Quality Improvement Act ("HCQIA" or "the Act"), 42 U.S.C.A. § 11101, et seq. (West 2005). For this reason, and because the district court found Wahi's other claims failed on the merits, the court awarded CAMC and [its Executive VP and CMO] summary judgment.").

Wieters v. Roper Hosp., 58 Fed. App’x 40, 41, 46 (4th Cir. 2003) ("The district court granted summary judgment to the hospital on immunity grounds, and we affirm. ... Although [the physician] has pointed out parts of the process that did not hew strictly to the bylaws and the safe harbor provisions, he has presented nothing that would lead a reasonable jury to find by a preponderance of the evidence that the hospital treated him unfairly under the circumstances.”).

Procedure

Brooks v. City of Winston-Salem, 85 F.3d 178 (4th Cir. 1996)

Francis v. Giacomelli, 588 F.3d 186 (4th Cir. 2009)

Nemet Chevrolet v. Consumeraffairs.com, 591 F.3d 250 (4th Cir. 2009)