Becker's Hospital Review

15 CFO / FINANCE Hartford HealthCare hit with antitrust claims by rival By Ayla Ellison T wo healthcare organizations in Hartford, Conn., are battling in federal court. Saint Francis Hospital and Medical Cen- ter in Hartford filed a lawsuit Jan. 11 against Hartford HealthCare alleging the health system monopolized regional medical care by acquiring physician practices and demanding physicians refer cases to its facilities, regardless of whether that was best for patients. "As a result of its acquisitions of physician practic- es and other anti-competitive conduct, Hartford HealthCare has substantially increased its hos- pital market share to dominant levels," states the complaint pending in Connecticut federal court. "At these dominant levels, Hartford HealthCare is in a position to dictate higher prices to health plans, thereby increasing healthcare costs to health plan members and patients." Hartford HealthCare took the anti-competitive actions to increase market dominance, the law- suit alleges. System executives allegedly repeated- ly stated during meetings that their plan was to "crush" Saint Francis Hospital. "In every case where Hartford HealthCare has acquired a physician practice involving a physi- cian who previously focused his or her patient care at Saint Francis, the physician has shied all or virtually all of his or her cases to Hart- ford HealthCare," the complaint states. "Serious harm to Saint Francis will cause significant harm throughout the market, because only Saint Fran- cis can provide a serious challenge to Hartford HealthCare's market position." e complaint alleges that the anti-competitive actions have harmed local hospitals, health plan members and patients. e lawsuit seeks dam- ages and an injunction prohibiting Hartford HealthCare's alleged anti-competitive conduct. Hartford HealthCare said the complaint is merit- less and that it will defend against the allegations. "Our focus remains on serving the needs of our patients and our communities during this rag- ing pandemic, as we care for more hospitalized COVID-19 patients than ever before," the system said in a Jan. 11 statement to Becker's. n HCA Healthcare buys 59 urgent care centers in Florida By Alia Paavola N ashville, Tenn.-based HCA Healthcare finalized the purchase of MD Now Urgent Care, a network of 59 urgent care centers in Florida. The transaction involving Florida's largest urgent care chain, an- nounced Jan. 4, significantly expands HCA's reach as an urgent care pro- vider. HCA operates 170 urgent care clinics in 19 markets. "The addition of MD Now Urgent Care in Florida enhances our already strong capabilities in a rapidly growing state by providing convenient outpatient care options for our patients," said Sam Hazen, CEO of HCA Healthcare. "It also connects MD Now patients to a comprehensive state- wide network of care, including acute care and specialty services should they be needed." HCA said the transaction closed at the end of 2021; the terms of the trans- action were not disclosed. HCA said it has invested heavily in the Florida market, including $3 billion in capital projects over the last three years. n UnitedHealthcare assures no changes to ER coverage policy in 2022 By Nick Moran U nitedHealthcare will not enact a controversial policy regarding emer- gency care coverage in 2022, according to a Dec. 30, 2021, letter CEO Brian Thompson wrote to the American Hospital Association. UnitedHealthcare came under fire from the AHA and other healthcare or- ganizations in 2021 over its attempts to reform its emergency care cover- age. The payer unveiled a policy that would allow it to deny coverage of emergency room visits if an internal investigation found the condition did not require emergent care. The payer later announced it would delay integrating the policy after re- ceiving feedback from providers, but some groups, including the Feder- ation of American Hospitals, demanded UnitedHealthcare permanently rescind the policy. AHA described similar fears in a Dec. 29, 2021, bulletin, claiming United- Healthcare sought to go forward with changes to its emergency coverage criteria and expressed its disapproval of the policy. According to the bul- letin, the payer would have rolled out the changes Jan. 1. However, in a Dec. 30, 2021, letter responding to AHA, Mr. Thompson said UnitedHealthcare would not make any changes to its policies. "Our intention to align coverage definitions with the new guidance creat- ed confusion rather than clarifying matters," he wrote. "To reiterate, there is no new policy regarding coverage criteria for emergency care being implemented on Jan. 1, 2022. Further, UnitedHealthcare has no intention of implementing any such new policy for its fully insured business." An AHA spokesperson told Becker's that it takes UnitedHealthcare at its word that the organization misinterpreted the payer's language. n

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