RunningOnPunkTime t1_je4zp7d wrote
Reply to comment by ktxhopem3276 in Gainey is set to unveil plans to challenge the tax-exempt status of more than a dozen properties in the city, including UPMC and a Propel School on the North Side by sugarandspice85
Are we just going to ignore their monopolizing tendencies?
ktxhopem3276 t1_je50gfv wrote
I think the nonprofit debate is a distraction from the monopolization issue. They should be forced to divest at least two hospitals in the county.
dazzleox t1_je5cma5 wrote
They're not different issues because congress has granted anti trust exemptions to non profit hospital systems, and seems unlikely to change that.
ktxhopem3276 t1_je5dc46 wrote
Could you share a source on that issue? I’m not finding much.
https://lowninstitute.org/why-antitrust-laws-arent-stopping-some-hospital-mergers/
This says the states can take antitrust action against hospitals
dazzleox t1_je5fe3e wrote
The Vanderbilt piece is from 1999 when, say it says, circuit courts were divided on the non profit factor. The way the case law has since settled is the FTC retains jurisdiction to review mergers regardless of status, it is prohibited to enforce anti trust laws against non profit health care entities generally. UPMC's growth lately has not been mergers but building new facilities.
FTC Chairman Joseph Simons said his team would like to do more to address Grassley's concerns but that they are butting up against statutory limitations.
"We're very interested in looking at unilateral conduct by hospitals, that are problematic under the antitrust laws," Simons said. "But, generally when we do that, we find that they're nonprofits, and we don't have jurisdiction over them."
"That's another reason why we've been asking the Congress to eliminate our exemption for nonprofits," Simons said.
"Gosh, I never gave that any thought," Grassley replied. "We ought to consider that."
I'm generalizing a bit. The DOJ retains jurisdiction over non profit hospitals but a more narrow set of issues, but has gone after some for wage collusion.
ktxhopem3276 t1_je5g1xw wrote
> Unlike the FTC, the DOJ does have authority over nonprofits, said Makan Delrahim, assistant attorney general for the DOJ's antitrust division.
Also, what is stoping the state from regulating UPMC?
dazzleox t1_je5my93 wrote
DOJ has jurisdiction over a fairly narrow set of issues though, like bribery/FCPA and criminal matters. That's good but it would take the FTC to break up a hospital system or HMO, and that would take an act by congress and/or a better SCOTUS.
The state could pass more regulations regarding hospitals, as long as it's not preempted. But state anti trust law is complicated in that some things would preempted and some would not, but either way, I don't imagine new laws passing a divided state legislature that does very little except at budget time. PA anti trust law is generally aimed at gas station price fixing, resale price maintenance, bid rigging for state contracts -- not at big stuff that the feds handle like corporate mergers.
ktxhopem3276 t1_je5plt1 wrote
How does the FTC decided what is nonprofit and what isn’t? Wouldn’t it use IRS rules instead of the PA law at issue here?
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