DOJ tried to drive home that while the industry at hand in this case is complex, the case has a simple antitrust answer. The presumption of unlawfulness was too much for Aetna to overcome. There may be alternatives, divestitures, and regulation, but the central question of the case will always be: is MA competition something worth preserving? Judge Bates asked very specific questions about benchmarks he should be looking to about entry success, timeframe with regard to compet

The witnesses today were Christine Hammer and Professor Aviv Nevo. Both sides summed up their arguments. Ms. Hammer stated that she was told Aetna would provide an outcome based analysis, but found no evidence of one, and that Mr. Gokhale's efficiency numbers were not verifiable. The defense countered that Aetna had learned from its merger with coventry, and efficiencies then included concurrent review, reimbursement reforms, procurement, network savings, and all these effici

On December 21, a report was released by Senators Susan Collins and Claire McCaskill, the respective Chairman and Ranking Member of the Senate Aging Committee. The report, entitled “Sudden Price Spikes in Off-Patent Prescription Drugs: The Monopoly Business Model that Harms Patients, Taxpayers, and the U.S. Health Care System,” is the culmination of several years of investigations into bad behavior surrounding a handful of specific drugs. By identifying common elements of the

The witnesses were Jonathan Orszag and Christine Hammer (an independent consultant hired to evaluate the efficiencies). The defense gave Orszag plenty of time to explain why Professor Nevo's merger analysis was wrong, while DOJ tried to discredit Orszag and point out flaws in his arguments. In response to questioning, Orszag said that recent studies showed greater nesting parameters for MA and traditional Medicare, and that Professor Nevo had incorrectly oversimplified his me

The two witnesses today were Rajiv Gokhale (Executive Vice President of Compass Lexicon LLC) and Jonathan Orszag (Senior Managing Director at Compass Lexicon LLC).Gokhale focused on the efficiencies that would result from the merger, and Orszag stressed that the merger would not harm competition. Gokhale was not very convincing; Orszag seemed much more competent. Gokhale, in response to defense questioning, claimed that substantial efficiencies would result from the Aetna-Hum

The witnesses for today were Katherine Coleman (Director of the Medicare Drug & Health Plan Contract Administration Group at CMS), Kevin Counihan (Director and CEO of Marketplace at CMS), Shawn Guertin (Executive Vice President and Chief Financial Officer at Aetna), and David Horst (Executive Director at Aetna). Katherine Coleman testified that CMS seeks to protect beneficiaries in Medicare Advantage (MA) and if the Aetna-Humana merger is approved, CMS will do its best to pro

The witnesses for today were Dr. J. Mario Molina (President and CEO of Molina) and Lisa Rubino (Senior Vice President for Medicare for Molina). The defense presented Molina as a major, rapidly growing company that was up to the divestiture challenge while DOJ worked to portray Molina as ill equipped to compete in health insurance markets. Dr. Molina claimed that Molina had grown over the past 35 years, and that it specialized in government programs (Medicaid) and would do wel

The witnesses for today were Mr. James Paprocki (works for Aetna), Leslie Carolina Kirk Koffman (sales manager for Humana in Kentucky), Cynthia Fulmer (works for Aetna, has responsibility for the Deep South and mid-South markets), Jeff Fernandez (Vice President of Humana's Western Segment) and Dr. J. Mario Molina (President and CEO of Molina). The defense argued that competition was very robust in Medicare Advantage (MA) markets, that a variety of seniors chose MA for a varie

The witnesses today were Professor Aviv Nevo and the first defense witness, Bruce Broussard (CEO of Humana). DOJ concluded that the merger would drastically reduce competition and lead to higher prices, and the defense began to present why the merger was a good transaction, why competition would not be harmed, and that new companies could enter the market. DOJ reviewed yesterday's testimony, and Professor Nevo concluded that the merger would reduce competition and increase co

The witnesses for today were Aetna CEO Mark Bertolini, Steven Kelmar (Aetna's Executive Vice President), Karen Lynch (Aetna's President), Jonathan Mayhew (Aetna's head of individual and public exchange business) and Professor Aviv Nevo (professor at Northwestern who analyzed the likely effects of the merger). DOJ is summing up their case, arguing that any efficiencies aren't merger specific, Aetna withdrew from the public exchanges to retaliate for DOJ's lawsuit, and that the