The U.S. District Court for the Southern District of Illinois has dismissed exclusive dealing allegations against BlueCross and BlueShield of Illinois, but a hospital that was also named in the antitrust lawsuit was not as lucky, according to a JD Supra Business Advisor report.
Marion (Ill.) HealthCare, an ambulatory surgical center, filed the lawsuit against Carbondale, Ill.-based Southern Illinois Healthcare and BCBSIL — the dominant insurer in the region. Marion HealthCare alleges that SIH has a 77 percent market share for inpatient surgical cases and a 76 percent market share for outpatient surgical cases within the relevant geographic area. Due to its dominant market share, SIH is a "must have" hospital for insurers, according to the lawsuit.
BCBSIL has an exclusive contract with SIH, which prohibits the insurer from contracting with SIH's competitors, including Marion HealthCare. Due to the contract, BCBSIL denied multiple applications submitted by Marion HealthCare seeking acceptance as a BCBSIL in-network provider, according to the report.
Marion HealthCare alleges in its lawsuit that as long as the arrangement between SIH and BCBSIL exists, ASCs like itself cannot remain competitive in the region.
The court dismissed Marion HealthCare's claims against BCBSIL, as the court held that the insurer "acted solely as a purchaser of services and thus cannot be held liable for an exclusive dealing contract," according to the report.
However, the court refused to dismiss the claims against SIH for a number of reasons, including its finding that the healthcare provider's market power in the region could possibly prevent entry into the in-network surgical services market of BCBSIL, according to the report. With BCBSIL out of the case, SIH must now face the antitrust claims alone.
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