Antitrust Law Daily Wrap Up, ANTITRUST NEWS: New York AG settles claims that UnitedHealth Group abused market share, (Jan 7, 2016)

By Greg Hammond, J.D.

UnitedHealth Group, Inc. has agreed to settle New York Attorney General Eric T. Schneiderman’s claims that the managed health care company used its significant market share in other insurance products to pressure skilled nursing facilities to contract for United’s institutional special needs plan. Schneiderman was concerned that United’s contracting practices in New York may have unlawfully harmed competition in violation of the Donnelly Act.

United offers a number of health insurance plans in the State of New York, including employer-sponsored and individual insurance plans. Attorney General Schneiderman claims, however, that—in some instances—United used its market position with regard to commercial, Medicare, and Medicaid insurance plans to pressure nursing facilities to also accept the United institutional special needs plan (I-SNP), which could foreclose competition and artificially limit consumer choice.

According to the terms of the settlement agreement, United may not require a skilled nursing facility to participate in its I-SNP as a condition for participation by that facility in one of United’s other insurance plans. Second, United may not penalize a skilled nursing facility for declining to participate in United’s I-SNP by offering the SNF lower reimbursement rates than similarly-situated SNFs, or by terminating or declining to renew a contract for non-I-SNP United insurance plans. Lastly, United has agreed to pay the state $100,000 in consideration of the making and execution of the agreement.

Companies: UnitedHealth Group, Inc.

News: Antitrust NewYorkNews