Title IX and tiering: Court of Appeals provides clarity

The U.S. Court of Appeals for the District of Columbia upheld, in Presbyterian Medical Center of the University of Pennsylvania Health System v. Shalala, 170 F.3d 1146 (D.C. Cir. 1999), a federal district court ruling granting summary judgment to the Department of Health and Human Services (DHHS) in a case in which Presbyterian Medical Center (PMC) challenged Medicare's requirement of contemporaneous documentation of $828,000 in graduate medical education (GME) expenses prior to increasing reimbursement amounts. DHHS Secretary Donna Shalala denied PMC's request for reimbursement for increased GME costs. The appellants then brought suit in federal court challenging the legality of an interpretative rule that requires requested increases in reimbursement to be supported by contemporaneous documentation. PMC also alleged that an error was made in the administrative proceedings to prejudice its claims because Aetna, the hospital's fiscal intermediary, failed to provide the hospital with a written report explaining why it was denied the GME reimbursement.

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Antitrust: U.S. Supreme Court Affirms FTC Jurisdiction but Vacates Scope of Analysis on CDA Policy

The Journal of Law Medicine & Ethics ◽

10.1017/s1073110500012912 ◽

1999 ◽

Vol 27 (2) ◽

pp. 197-198

Author(s):

Joseph R. Zakhary

Keyword(s):

Public Relations ◽

Supreme Court ◽

Federal Trade Commission ◽

Ninth Circuit ◽

Court Of Appeals ◽

For Profit ◽

Rule Of Reason ◽

Antitrust Analysis ◽

Business Financing ◽

The U.S

In California Dental Association v. FTC, 119 S. Ct. 1604 (1999), the U.S. Supreme Court reviewed a decision by the U.S. Court of Appeals for the Ninth Circuit that a nonprofit affiliation of dentists violated section 5 of the Federal Trade Commission Act (FTCA), 15 U.S.C.A. § 45 (1998), which prohibits unfair competition. The Court examined two issues: (1) the Federal Trade Commission's (FTC) jurisdiction over the California Dental Association (CDA); and (2) the proper scope of antitrust analysis. The Court unanimously held that CDA was subject to FTC's jurisdiction, but split 5-4 in its finding that the district court's use of abbreviated rule-of-reason analysis was inappropriate.CDA is a voluntary, nonprofit association of local dental societies. It boasts approximately 19,000 members, who constitute roughly threequarters of the dentists practicing in California. Although a nonprofit, CDA includes for-profit subsidiaries that financially benefit CDA members. CDA gives its members access to insurance and business financing, and lobbies and litigates on their behalf. Members also benefit from CDA marketing and public relations campaigns.

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The Eleventh Circuit Holds that Agreements in which Pharmaceutical Companies Pay Generic Companies Not to Compete May be Valid

The Journal of Law Medicine & Ethics ◽

10.1017/s107311050000749x ◽

2004 ◽

Vol 32 (1) ◽

pp. 181-184

Author(s):

Amy Garrigues

Keyword(s):

Pharmaceutical Companies ◽

Court Decisions ◽

Patent Holder ◽

Trial Court ◽

Court Of Appeals ◽

The Us ◽

Antitrust Laws ◽

Per Se ◽

Appeals Court ◽

Two Sides

On September 15, 2003, the US. Court of Appeals for the Eleventh Circuit held that agreements between pharmaceutical and generic companies not to compete are not per se unlawful if these agreements do not expand the existing exclusionary right of a patent. The Valley DrugCo.v.Geneva Pharmaceuticals decision emphasizes that the nature of a patent gives the patent holder exclusive rights, and if an agreement merely confirms that exclusivity, then it is not per se unlawful. With this holding, the appeals court reversed the decision of the trial court, which held that agreements under which competitors are paid to stay out of the market are per se violations of the antitrust laws. An examination of the Valley Drugtrial and appeals court decisions sheds light on the two sides of an emerging legal debate concerning the validity of pay-not-to-compete agreements, and more broadly, on the appropriate balance between the seemingly competing interests of patent and antitrust laws.

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