Law360 (February 22, 2019, 7:03 PM EST) — In a trial likely to turn heavily on the words “best efforts” and claims of subterfuge, insurance giants Anthem Inc. and Cigna Corp. will square off in Delaware’s Chancery Court Mondayover a $54 billion merger that came unglued in 2017, with as much as $20.5 billion in damages hanging in the balance.

Depending on the outcome, payouts could swing by more than $37 billion between Anthem’s $20.5 billion damages bid and Cigna’s $16.5 billion ask after an expected 10-day trial in Wilmington before Vice Chancellor J. Travis Laster. As many as 44 witnesses are in line to testify, with a stack of court filings so high that the vice chancellor ordered a “paperless” proceeding, with documents to be shared via thumb drive.

At the heart of the case are Cigna’s claims that Anthem bungled regulatory and antitrust reviews triggered by the announcement of their merger in 2015. Anthem, the largest of the nation’s 36 Blue Cross Blue Shield Association insurers, accused Cigna’s top officers of sabotaging the deal in a disappointed snit over their potential roles in the post-closing business.

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By Law360 (February 26, 2019, 8:58 PM EST) — A 25-year veteran antitrust lawyer for Anthem Inc. testified Tuesday he was stunned by Cigna Corp.’s sudden and allegedly fatal resistance to their now-abandoned, $54 billion tie-up, in the second day of a multibillion-dollar Delaware Chancery Court trial over the collapsed deal.

“I’ve never seen anything like this before. Never, ever. And I don’t think I ever will again,” said George L. Paul of White & Case LLP, a deal counsel to Anthem and a 25-year antitrust litigation specialist. “Our ability to advocate really broke down. They were no longer rowing in the same direction and, frankly, they were drilling holes in the bottom of the boat.”

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Dozens of rural hospitals have shuttered in recent years, and these states are home to the most facing a high risk of doing the same.

By Gaby Galvin, Staff Writer

USNews.com

Feb 22, 2019

Hundreds of hospitals in rural America could close if their financial situations do not improve, a new analysis indicates.

People in rural communities, frequently burdened by physician shortages and older populations, often face more difficulty than their urban peers in accessing health care. Now, a new analysis from Navigant, a consulting firm based in Chicago, finds that about 1 in 5 rural hospitals – a total of 430 – are at high risk of closure due to their financial situations, potentially hindering many Americans’ access to care and affecting 150,000 hospital-related jobs.

“Our analysis shines a new light on a rural hospital crisis that must be addressed and could significantly worsen with any downturn in the economy,” David Mosley, co-author of the study and managing director at Navigant, said in a statement.

Rural communities already have lost dozens of hospitals. Between 2013 and 2017, 64 rural hospitals shut their doors, more than twice the number of closures in the previous five years, according to an August report from the federal Government Accountability Office. A dwindling number of patients who seek inpatient care and reductions in Medicare payments have helped drive their financial distress, researchers have found.

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Law360 (February 21, 2019, 6:52 PM EST) — The University of Pittsburgh Medical Center hit back Thursday at

Pennsylvania Attorney General Josh Shapiro’s efforts to force the hospital and insurance network back to negotiations with Highmark Inc., claiming in state and federal court that Shapiro overstepped his bounds by trying to modify consent decrees governing the two companies’ relationship.

UPMC filed a motion to dismiss Shapiro’s petition to Pennsylvania’s Commonwealth Court seeking to extend the consent decrees that gave some Highmark insurance customers cheaper, in-network access to UPMC hospitals past the decrees’ June 30, 2019, expiration date, along with a complaint in federal court claiming Shapiro had violated the law by trying to interfere with how UPMC managed its federal Medicare Advantage programs.

“General Shapiro’s proposed ‘modification’ is a misnomer as it repudiates the central terms of the consent decree — including the parties’ express termination date and the lack of full in-network contracts between UPMC and Highmark,” UPMC’s memorandum supporting the motion to dismiss says. “General Shapiro cannot ‘modify’ an agreement in a way that binds UPMC and Highmark, forever, in a way contrary to the original purpose of the consent decree.”

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By CHRISTOPHER SNOWBECK , STAR TRIBUNE 

February 11, 2019 – 9:02 AM

A Delaware Court has ruled that Scott Serota the CEO of the Blue Cross Blue Shield Association must appear at and testify at trial in the In Re: Anthem-Cigna Merger Litigation case.

Click to view the Order: Serota Order

Cigna has filed a Motion to Compel the Blue Cross Blue Shield Association to testify at trial through it’s CEO Scott Serota in the In Re Anthem-Cigna Merger Litigation in the Chancery Court of Delaware.

Click to view the Motion