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The healthcare deals under the microscope

Elevance's proposed $2.5 billion acquisition of Blue Cross and Blue Shield of Louisiana was put on hold in late September after the deal came under scrutiny from state senators and the attorney general.

The government officials called for a delay and made clear they did not want the sale to go forward until more questions were answered. The senators' call for a delay stemmed from reports commissioned by the state's insurance commission that questioned how BCBS planned to structure the deal. Attorney General Jeff Landry, a gubernatorial candidate, said he did not want the sale to proceed before a new governor and insurance commissioner have taken office. 

"Since we are committed to making sure these questions are answered, BCBSLA and Elevance Health do not believe it is the right time to hold public hearings and a policyholder vote," the companies said in a joint statement. 

The companies said they remain committed to the deal, and a BCBS spokesperson said they are hopeful it can still be closed by early 2024. 

The Elevance-BCBS Louisiana deal is not the only proposed payer acquisition coming under fire. A pair of federal lawmakers — Massachusetts Sen. Elizabeth Warren and Washington Rep. Pramila Jayapal — are calling on the Federal Trade Commission and the Justice Department's antitrust division to "carefully scrutinize" UnitedHealth Group's proposed $3.3 billion acquisition of home and hospice care provider Amedisys. 

The lawmakers expressed concern that the deal would increase UnitedHealth Group's market dominance, reduce competition, hurt patients and increase healthcare costs. 

The deal, first announced in June, is already under scrutiny from the Justice Department, which requested additional information about the proposed merger in August and extended the waiting period for the deal under federal law. 

Government scrutiny is hardly new for UnitedHealth Group. The lawmakers' letter was sent exactly one year after UntiedHealth's Optum arm completed its $7.8 billion merger with healthcare data and analytics giant Change Healthcare. The deal was finalized after a Washington, D.C., federal judge ruled in favor of the merger, rejecting a Justice Department lawsuit. The Justice Department sued in an attempt to stop the deal it called anticompetitive. 

In February, UnitedHealth Group closed a $5.4 billion acquisition of home health firm LHC Group. The deal received scrutiny from the FTC and was reportedly looking for vertical harm theories around the deal, but the agency ultimately did not challenge the acquisition.   

On the hospital side, Minnesota Attorney General Keith Ellison is reviewing the planned mergers between Duluth, Minn.-based Essentia Health and Marshfield (Wis.) Clinic Health System as well as Duluth-based St. Luke's and Wausau, Wis.-based Aspirus Health. The move comes amid changes in Minnesota law and the nixed merger between Sioux Falls, S.D.-based Sanford Health and Minneapolis-based Fairview Health following intervention from Mr. Ellison's office.

The state's healthcare entity transaction law has given the attorney general greater review powers to determine whether planned healthcare mergers are in the public interest. Mr. Ellison can seek court intervention if he deems such transactions are not.

A public meeting is scheduled for Oct. 25 to engage local communities as part of the review to ensure two proposed mergers in the state are in compliance with both federal and state law. 

Both Essentia Health and St. Luke's said they appreciate the opportunity to showcase the benefits of the potential mergers with the two respective Wisconsin systems through such scrutiny.


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