Assistant Attorney General Jonathan Kanter Announces Task Force on Health Care Monopolies and Crimes of Collusion Across the Commercial Health Insurance and Corporate Hospital Chain Industries
New Health Care Task Force will prosecute historic level of healthcare industry crime and harm | Office of Public Affairs U.S. Department of Justice | May 12, 2024
THURSDAY, MAY 9, 2024 | United States of America Department of Justice (Washington, D.C.) —The United States of America Justice Department today announced the formation of the Antitrust Division’s Task Force on Health Care Monopolies and Collusion (HCMC). The HCMC will guide the division’s enforcement strategy and policy approach in health care, including by facilitating policy advocacy, investigations and, where warranted, civil and criminal enforcement in health care markets.
“Every year, Americans spend trillions of dollars on health care, money that is increasingly being gobbled up by a small number of payers, providers and dominant intermediaries that have consolidated their way to power in communities across the country,” said Assistant Attorney General Jonathan Kanter of the Justice Department’s Antitrust Division. “Led by Katrina Rouse, the task force will identify and root out monopolies and collusive practices that increase costs, decrease quality and create single points of failure in the health care industry.”
The HCMC will consider widespread competition concerns shared by patients, health care professionals, businesses and entrepreneurs, including issues regarding payer-provider consolidation, serial acquisitions, labor and quality of care, medical billing, health care IT services, access to and misuse of health care data and more. The HCMC will bring together civil and criminal prosecutors, economists, health care industry experts, technologists, data scientists, investigators and policy advisors from across the division’s Civil, Criminal, Litigation and Policy Programs, and the Expert Analysis Group, to identify and address pressing antitrust problems in health care markets.
The HCMC will be directed by Katrina Rouse, a long-serving antitrust prosecutor who joined the Antitrust Division in 2011. She previously served as Chief of the division’s Defense, Industrials and Aerospace Section, Assistant Chief of the Division’s San Francisco Office, a Special Assistant U.S. Attorney and a Trial Attorney in the division’s Healthcare and Consumer Products Section. She holds degrees from Columbia University and Stanford Law School, and clerked for federal judges on the U.S. District Court for the District of Maryland and the U.S. Court of Appeals for the Fifth Circuit. Rouse will serve concurrently as the division’s Deputy Director of Civil Enforcement and Special Counsel for Health Care.
The Antitrust Division welcomes input and information from the public, including from practitioners, patients, researchers, business owners and others who have direct insight into competition concerns in the health care industry. Members of the public can share their experiences with the Task Force on Health Care Monopolies and Collusion by visiting HealthyCompetition.gov. Where appropriate, the division will refer matters to other federal and state law enforcers. [Updated May 9, 2024.]
(Minnesota-based UnitedHealth Group is one of the largest investment banking firms and private equity funds in the world. They are currently being investigated by five entities for crime. They are currently being sued by multiple medical clinic owners, mental health therapists and physicians for an array of crimes before and since February 2024. UnitedHealth Group has the largest Denial of Care by PxDx and nH Predict in the world.)
TOO BIG TO SUCCEED: WHAT IS PRIVATE EQUITY AND HOW DOES IT DRIVE CONSOLIDATION OF WEALTH AND POWER IN HEALTHCARE?
The Private Equity Stakeholder Project has studied the impacts of private equity investment in key healthcare sectors, including safety net hospitals, behavioral health, nursing homes, prisons and detention centers and dental care. They have also written about the practice of taking debt-funded dividends from healthcare companies; private equity’s role in medical debt collection; and the relationship of private equity ownership and Medicare fraud. The organization also tracks private equity healthcare acquisitions on a monthly basis, highlighting notable transactions in a variety of sectors.
The private equity industry is massive, hugely influential, and playing a harmful role in more and more aspects of life in the United States and around the world. The industry manages nearly $7.5 trillion in assets and owns companies that employ more than 11 million American workers, plus millions more around the world. The industry has harmed and killed patients and imposed Moral Injury on ethical medical professionals in a myriad of ways.
The Private Equity Stakeholder Project focuses not just on private equity but also other similarly structured private funds investments including:
Private equity
Private real estate
Private infrastructure
Private debt
Venture capital
Hedge funds (sometimes, when they act like private equity.)
HOW DO ANTITRUST CRIMES BY PRIVATE EQUITY HARM PATIENTS AND ETHICAL MEDICAL PROVIDERS?
Private equity increasingly makes up a substantial portion of investment in U.S. healthcare companies, touching virtually every sector of the industry, and is expected to continue to grow. Asset managers have record levels of available capital earmarked for healthcare investment; as of 2019, private equity firms had $29.2 billion in capital waiting to be invested in healthcare.
This is despite the fact that private equity investment in healthcare companies carries substantial risk to patients, workers, and ethical medical professionals. The typical private equity investment playbook—pursuing outsized returns over short time horizons while using high levels of debt—leads to behavior that jeopardizes patient care.
For example, private equity-owned healthcare companies have seen the following issues:
Reduced staffing, or filling beds without adequate staffing ratios
Over-reliance on unlicensed staff to reduce labor costs
Failure to provide adequate training
Pressure on providers to provide unnecessary and potentially costly services
Violation of regulations required for participants in Medicare and Medicaid such as anti-kickback provisions, creating litigation risk
(Private Equity utilizes an array of tactics and business practices that disregard health, healthcare and Public Health. Crime is frequently called “bad behavior” instead of crime.)
OPEN SOURCE RESOURCES FOR INVESTIGATIVE JOURNALISTS, PRODUCERS, BUSINESS EDITORS and HEALTHCARE INDUSTRY ACCOUNTABILITY REPORTERS
PE Bankruptcies in Healthcare Research
Overview of Private Equity deals in healthcare for 2023
Private Equity acquisitions across the healthcare-adjacent industry this year:
PE profiting from Medicare Advantage
PE-backed prison healthcare company YesCare
HARM BY PRIVATE EQUITY IN YOUR STATE
The Private Equity Risk Index reports on 16 key measures that reflect these risks to workers and jobs, state health care systems, housing availability, and the security of state pensions in each state. Where does your state rank on the harm scale?
ADDITIONAL READING
Private Equity Is Gutting America — and Getting Away With It by By Brendan Ballou | April 28, 2023 New York Times
SUBMIT EVIDENCE OF HARM TO THE DoJ
Submit evidence of harm to your clinic, practice or hospital by Private Equity firms, Commercial Health Insurance companies or Corporate Hospital Chains here. The autor-reply will state that submissions need to be “antitrust” specific. However, note: All of the harm being imposed is antitrust-related harm and crime.