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| Physician Law Review |
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| Antitrust |
| 7. |
Hospital Defenses to
Anitrust
Actions. |
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A. State Action
- Anti-competitive activities may be immune
from the antitrust laws if 1) the actions are
taken pursuant to an affirmatively expressed and
clearly articulated policy to supplant
competition expressed by the state, and 2) the
activities are subject to active state
supervision. California Retail Liquor Dealers
Assn. v. Midcal Aluminum, Inc., 445 U.S. 97
(1980).
- Judicial review of the hospital's
activities does not constitute sufficient state
involvement. Shahawy v. Harrison, 875 F.2d 1529
(11th Cir. 1989).
B. Quality of
Care
- Hospitals usually justify potentially
anti-competitive conduct on the basis that it is
required for quality of care. In most instances,
this is not a recognized defense to antitrust
suits although it is relevant under a rule of
reason analysis. The determining factor though
is not whether the quality of care will be
improved , but what the affect of the action is
on competition.
- The primary factor in determining whether
conduct taken to further patient care violates
the antitrust laws is whether the use of market
power unreasonably restrains competition. FTC v.
Indiana Federation of Dentists, 476 U.S. at
459.
- In Jefferson Parish
Hospital District No. 2 v. Hyde, the Supreme
Court ruled that the quality of care defense was
not sufficient to override anti-competitive
consequences. But see Wilk v. American Medical
Association, 719 F.2d 207 (7th Cir. 1983), cert.
denied, 467 U.S. 1210 (1984) (once plaintiff
proves a restraint of trade, the defendant can
present patient care defense by presenting
evidence regarding the basis for the
action).
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