ANTITRUST

Abraham v. Intermountain Health Care, Inc., No. 05-4043 (10th Cir. Sept. 6, 2006)

When a group of Utah optometrists appealed a decision of the district court, denying their efforts to become panel providers for the largest managed health care company in the state, the Tenth Circuit Court of Appeals rejected their claims that an HMO's decision to exclude them from its provider panel violated the Sherman Act. In 2001, the optometrists filed suit against the HMO and others, alleging that the HMO's exclusion of optometrists from its network of providers violated §§ 1 and 2 of the Sherman Act. The district court granted summary judgment in favor of the defendants on all claims. The optometrists appealed.

The Tenth Circuit affirmed the decision of the district court, holding, with respect to the plaintiffs' group boycott claim, that there was not sufficient evidence of an agreement designed to unreasonably restrain trade between the HMO and its panel ophthalmologists simply because the HMO acted in response to the ophthalmologists' complaints regarding adding optometrists to the HMO's provider panel. The court found no evidence of collusion between the HMO and its panel ophthalmologists, and found that the HMO's provider agreement did not limit where a panel provider referred his or her non-HMO patients. The court held that the plaintiff optometrists failed to present enough evidence from which a jury might infer an antitrust conspiracy, or evidence showing that the HMO excluded optometrists in exchange for an agreement by its panel ophthalmologists to direct their discretionary patients to HMO facilities, and that plaintiffs were required to present evidence showing something more than mere acquiescence to a competitor's complaints about a price-cutter in order to infer a conspiracy. The court determined that the HMO may have acted independently in deciding not to panel optometrists in a certain geographic area.

With regard to the plaintiffs' tying claim, the court held that this claim failed because the HMO had no economic interest in the sale of non-surgical eye care. Similarly, with regard to the plaintiffs' § 2 claims, the Tenth Circuit held that, because the concept of "antitrust standing" is distinct from that of constitutional standing (and requires an "antitrust injury"), the plaintiffs lacked standing with respect to both their request for damages under § 4 of the Clayton Act as well as their request for injunctive relief under § 16 of the Clayton Act to pursue this claim, because the plaintiffs failed to delineate any injury they had suffered or would suffer that was associated with the HMO's dominance in the surgical facilities market, or to explain how that injury was "of the type the antitrust laws were designed to prevent and that [flowed] from that which makes defendants' acts unlawful." Accordingly, the Tenth Circuit affirmed the decision of the district court granting summary judgment to the defendants on all claims.