United States v. Blue Cross Blue Shield of Michigan
United States District Court for the Eastern District of Michigan
809 F.Supp.2d 665 (2011)
Blue Cross Blue Shield of Michigan (BCBS) (defendant), the state's largest health insurer, required hospitals to include most-favored-nation clauses in their agreements, forcing hospitals to charge BCBS's competitors substantially higher prices (up to 40 percent more) or refuse hospitals that declined such clauses lower reimbursement rates (up to 16 percent less); the United States and Michigan (plaintiffs) sued alleging Sherman Act and state antitrust violations, and BCBS moved to dismiss, arguing no anticompetitive effects resulted from the clauses.
Whether a dominant health insurer's use of most-favored-nation clauses in hospital agreements, which raise competitors' costs and reduce their ability to compete, unreasonably restrains trade under § 1 of the Sherman Act.