In a case brought by House Republicans, a federal district judge ruled on May 12 that the cost-sharing subsidies are illegal. Congress had never explicitly appropriated those funds. The White House contends that the authority to spend the money is in the ACA statute itself. The judge didn’t buy it. Continue reading
Here’s a story that’s easy to overlook but could affect the future of health care cost and quality management. On Dec. 2,* the U.S. Supreme Court will hear arguments in Gobeille v. Liberty Mutual, a case that could determine whether states can include data from employer-sponsored health plans when compiling information for all-payer claims databases (APCDs).
If you don’t look closely at the case, it may appear to be nothing more than arcane wrangling over whether employers can use a 1974 law to shield themselves from having to share their health insurance data with the public. But it has important implications for the 18 states that have passed laws to develop APCDs, and 20 others that are considering such legislation. Continue reading
Today, the U.S. Supreme Court ruled that the North Carolina state dental board does not have the authority to regulate teeth-whitening businesses.
In a 6-3 decision, the justices found the North Carolina Board of Dental Examiners, which is comprised mostly of dentists, illegally quashed competition from non-dentists who sought to open teeth-whitening shops in the state. The decision, which upheld a lower court’s ruling, has the potential to impact other professional licensing boards across the country, experts say. Continue reading
A long-simmering feud between North Carolina’s state dental board and a group of non-dentists who provide teeth-whitening services in malls and day spas is headed for the U.S. Supreme Court. Oral arguments in the case, North Carolina Board of Dental Examiners v. Federal Trade Commission, are scheduled for Oct. 14, the ADA (American Dental Association) News reports.
The decision could have wider implications for teeth-whitening shops – and for the dental and medical boards that regulate the health professions nationwide. Dental whitening has grown into a big business in recent years and, in a number of states, dental boards have taken steps to make the services illegal for anyone but dentists or hygienists to perform. Campbell Robertson provided a thorough look at the topic in a story last year for The New York Times.
In North Carolina, the Federal Trade Commission (FTC) has taken the side of the retail teeth-whitening shops. In 2011, the commission held that North Carolina’s state dental board “illegally thwarted competition by working to bar non-dentist providers of teeth whitening goods and services from selling their products to consumers.”
Last year, the U.S. Court of Appeals for the Fourth Circuit upheld the FTC’s ruling.
But the North Carolina dental board argues that its actions are not subject to such challenges because federal antitrust laws do not apply to actions taken by a state or its agencies. Continue reading
One of the most significant trends in health care over the past few years has been the merger of physician groups with hospitals. By acquiring physician groups, hospitals and health systems can develop accountable care organizations and gain a competitive advantage by requiring employed physicians to refer patients to them.
But last week a federal judge in Idaho ruled that St. Luke’s Health System in Boise had violated antitrust law by acquiring the 40-physician Saltzer Medical Group, in nearby Nampa, Idaho, in December 2012. At the time, Saltzer was the largest independent multispecialty group practice in the state. As result of the antitrust violation, the judge said the hospital had to unwind the acquisition.
Given that the Federal Trade Commission was a plaintiff in the case, the decision raises a question about whether the FTC will pursue antitrust cases in other cases when hospitals acquire physician groups. The decision on Friday by B. Lynn Winmill, chief judge of the U.S. District Court in Idaho, marked the first time a federal court had decided an FTC case against a hospital acquiring a physician practice, as Beth Kutscher explained in Modern Healthcare. Continue reading