An MCO Guide to Navigating Mergers and Acquisitions Amid Heightened Antitrust Enforcement

May 3, 2024 1:30pm

Mike Cowie
Partner
Dechert LLP

Dan Howley
Partner
Rule, Garza, Howley LLP

The Biden Administration is hyper focused on antitrust in healthcare. In the past few years the DOJ and have challenged several significant deals, with mixed success. New merger guidelines reflect a willingness to investigate or challenge more deals.

  • Tracking the antitrust impact of expansion into new areas, such as physician services, hospital related services, and home healthcare in the healthcare industry
  • Understand what regulators look for in assessing a proposed health plan merger and how to prepare for and respond to antitrust scrutiny
    • Developing an effective internal and external communication strategy to avoid problematic language that could impact the deal
    • Examples of documents in proposed plan mergers that impacted decision making by government authorities
  • Examining what’s new in the HSR process
  • Anticipating the impact of federal draft merger guidelines on future deals involving MCOs
  • Analyzing recent deals that received scrutiny, including DOJ challenges to MCO deals that were unsuccessful
    • CVS acquisition of Oak Street, Signify Health
    • UnitedHealth and Change Healthcare case
  • Explore how payors manage concerns about channel conflict in the context of vertical integration