UPMC prevails in workers’ comp antitrust lawsuit

UPMC prevails in workers' comp antitrust lawsuit

UPMC prevailed in an antitrust lawsuit accusing the Pittsburgh-based integrated health system of driving out a competitor that offers workers’ compensation administrative services.The 3rd U.S. Circuit Court of Appeals denied Premier Comp Solutions’ request to add a defendant to the amended complaint after the court’s deadline. Judge Thomas Hardiman wrote in an opinion Aug. 12 that Premier failed to show “good cause” for its delay.Premier did not respond to a request for comment. Premier claimed that UPMC violated antitrust laws by engaging in anticompetitive practices, fraud and misrepresentation. In 2006, Premier reached an agreement with UPMC’s WorkPartners to provide bill review and repricing services for several UPMC clients. That agreement expanded in 2010 to include panel development, where Premier directed employees who are hurt on the job to certain providers, as well as appointment scheduling, injury management and physical therapy and imaging network services. But after UPMC received a trove of medical record data, the health system informed Premier that it was ending its repricing contract, according to the amended complaint. UPMC allegedly used the experience and related information from its “trade secret panel provider database” to improve its subsidiaries and justify the decision to stop working with Premier. UPMC also stopped using Premier for its panel development services. In addition to the contract disputes, Premier claimed that UPMC required Premier to schedule physical therapy with UPMC’s Centers for Rehab Services. The health system also mandated that its owned and affiliated physicians were prioritized in the provider panels, among other anticompetitive practices stipulated in the amended complaint. But the court ruled that Premier did not meet the legal burden of establishing a relevant geographic market pertaining to the antitrust complaints or submit evidence of a monopoly in those markets.The judges said Premier also didn’t show it was a competitor of UPMC to justify the antitrust claims. Premier was in a vertical relationship with WorkPartners, not a horizontal relationship, and was not a competitor, the court ruled. The 3rd Circuit also tossed out Sherman Act allegations.”UPMC defendants do not present a dangerous probability of obtaining monopoly power based upon the undisputed facts,” the memorandum opinion stated. Premier also failed to adequately demonstrate noncompetitive effects of the alleged misappropriation of trade secrets.

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