Organized medicine calls on court to block Nevada health plan merger

Doctors say the government's approval of the transaction ignored several risks to competition that would harm patient care. United says it's a done deal.

By Amy Lynn Sorrel, AMNews staff. June 9, 2008.

Physicians are challenging the Dept. of Justice's decision to conditionally approve the merger of UnitedHealth Group -- the nation's largest health insurer -- and Sierra Health Services Inc. -- Nevada's largest health plan.

The American Medical Association, Nevada State Medical Assn. and Clark County Medical Society on May 15 filed comments asking the U.S. District Court for the District of Columbia to reject the Justice Dept.'s proposed judgment. The ruling, which is subject to court approval, was conditioned on United selling its Las Vegas Medicare business, which had more than 25,000 enrollees.

The $2.6 billion merger, first proposed in March 2007, was completed on Feb. 25. The sale of United's Medicare business to Humana was finished May 1. The court could overturn the United-Sierra union or force changes in the combined firm.

Doctors say the Justice Dept. decision, if upheld, would put patient care at risk and could set a dangerous precedent.

"This is an egregious example of monopolistic behavior by the insurance industry that is not allowed in other industries," said AMA Board of Trustees Chair Edward L. Langston, MD.

The merger would give United 56% of the overall commercial health insurance market in Las Vegas and more than 90% of the commercial HMO market, AMA data show. Historically, Dr. Langston said, such mergers have diminished access to care and produced higher premiums.

The court will determine whether the government's proposed action is in the public interest.