Heartland Surgical Specialty Hosp. v. Midwest Div., Civil Action No. 05-2164-MLB.

• Decision Date: 01 October 2007
• Docket Number: Civil Action No. 05-2164-MLB.
• Citation: 527 F.Supp.2d 1257
• Parties: HEARTLAND SURGICAL SPECIALTY HOSPITAL, LLC, Plaintiff, v. MIDWEST DIVISION, INC. d/b/a HCA Midwest Division, et al., Defendants.
• Court: U.S. District Court — District of Kansas

527 F.Supp.2d 1257

HEARTLAND SURGICAL SPECIALTY HOSPITAL, LLC, Plaintiff, v. MIDWEST DIVISION, INC. d/b/a HCA Midwest Division, et al., Defendants.

Civil Action No. 05-2164-MLB.

United States District Court, D. Kansas.

October 1, 2007.

COPYRIGHT MATERIAL OMITTED

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Eric L. Dirks, Norman E. Siegel, Patrick J. Stueve, Rachel E. Schwartz, Todd

M. McGuire, Virginia Stevens Crimmins, Stueve Siegel Hanson LLP, Kansas City, MO, for Plaintiff.

Brian E. Kowalski, Eric J. McCarthy, Margaret M.L. Zwisler, Marguerite M. Sullivan, Latham & Watkins, Washington, DC, David E. Everson, Jr., R. Kent Sullivan, Russell J. Keller, Stinson Morrison Hecker LLP, Jeffrey J. Simon, Leonard L. Wagner, M. Jared Marsh, Michael S. Hargens, William A. Lynch, Husch & Eppenberger, LLC, Floyd R. Finch, Jr., Laura K. Brooks, Shelley A. Runion, Blackwell Sanders LLP, John D. Seaton, Lewis, Rice & Fingersh, LC, John M. McFarland, Scott E. Harvison, Kutak Rock LLP, David A. Jermann, II, Edward R. Spalty, Gerald A. King, Armstrong Teasdale LLP, Kansas City, MO, Allen Spencer Boston, David B. Helms, Richard. B. Walsh, Jr., Winthrop B. Reed, III, Lewis, Rice & Fingersh, LC, St. Louis, MO, David A. Ettinger, Peter E. Boivin, Honigman Miller Schwartz & Cohn, Detroit, MI, Harry Christopher Goplerud, Honigman Miller Schwartz Dand Cohn LLP, Tampa, FL, Lara Fetsco Phillip, Honigman Miller Schwartz and Cohn LLP, Bloomfield Hills, MI, for Defendants.

MEMORANDUM AND ORDER

MONTI L. BELOT, District Judge.

                TABLE OF CONTENTS
                  I. INTRODUCTION .......................................................... 1263
                 II. PROCEDURAL HISTORY .................................................... 1263
                III. FACTS ................................................................. 1264
                     A. The Healthcare Industry ............................................ 1265
                     B. Heartland .......................................................... 1266
                     C. The Individual Defendants .......................................... 1267
                        1. Aetna ........................................................... 1267
                        2. Coventry ........................................................ 1267
                        3. Blue Cross ...................................................... 1267
                        4. United .......................................................... 1267
                        5. Cigna ........................................................... 1268
                        6. Humana .......................................................... 1268
                        7. HCA Midwest ..................................................... 1268
                        8. Saint Luke's .................................................... 1268
                        9. Shawnee Mission Medical Center .................................. 1268
                        10. North Kansas City Hospital ..................................... 1268
                        11. Carondelet ..................................................... 1268
                     D. Contractual Relationships Between the Defendants ................... 1268
                        1. Aetna's Relationships ........................................... 1268
                           a. Aetna—HCA Midwest ............................................ 1268
                           b. Aetna—Saint Luke's ........................................... 1270
                           c. Aetna—Shawnee Mission Medical Center ......................... 1270
                           d. Aetna—North Kansas City Hospital ............................. 1270
                           e. Aetna—Carondelet ............................................. 1270
                        2. Coventry's Relationships ........................................ 1271
                           a. Coventry—HCA Midwest ......................................... 1271
                           b. Coventry—Saint Luke's ........................................ 1272
                           c. Coventry—Shawnee Mission Medical Center ...................... 1273
                           d. Coventry—North Kansas City Hospital .......................... 1274
                           e. Coventry—Carondelet .......................................... 1274
                        3. Blue Cross's Relationships ...................................... 1274
                           a. Blue Cross—HCA Midwest ....................................... 1274
                           b. Blue Cross—Saint Luke's ...................................... 1275
                           c. Blue Cross—Shawnee Mission Medical Center .................... 1275
                

                           d. Blue Cross—North Kansas City Hospital ........................ 1275
                           e. Blue Cross—Carondelet ........................................ 1275
                        4. United's Relationships .......................................... 1275
                           a. United—HCA Midwest ........................................... 1275
                           b. United—Saint Luke's .......................................... 1275
                           c. United—Shawnee Mission Medical Center ........................ 1275
                           d. United—North Kansas City Hospital ............................ 1275
                           e. United—Carondelet ............................................ 1276
                        5. Cigna's Relationships ........................................... 1276
                           a. Cigna—HCA Midwest ............................................ 1276
                           b. Cigna—Saint Luke's ........................................... 1276
                           c. Cigna—Shawnee Mission Medical Center ......................... 1276
                           d. Cigna—North Kansas City Hospital ............................. 1276
                           e. Cigna—Carondelet ............................................. 1276
                        6. Humana's Relationships .......................................... 1276
                           a. Humana—HCA Midwest ........................................... 1276
                           b. Humana—Saint Luke's .......................................... 1277
                           c. Humana—Shawnee Mission Medical Center ........................ 1277
                           d. Humana—North Kansas City Hospital ............................ 1277
                           e. Humana—Carondelet ............................................ 1277
                     E. Heartland's Attempts to Obtain MCO Contracts ....................... 1277
                        1. Aetna ........................................................... 1277
                        2. Coventry ........................................................ 1278
                        3. Blue Cross ...................................................... 1280
                        4. United, Cigna, and Humana ....................................... 1280
                     F. Defendants' Internal Expressions Concerning Specialty Hospitals .... 1280
                        1. MCO Defendants .................................................. 1280
                        2. Hospital Defendants ............................................. 1281
                           a. HCA Midwest .................................................. 1281
                           b. Saint Luke's ................................................. 1282
                           c. Shawnee Mission Medical Center ............................... 1282
                           d. Carondelet ................................................... 1283
                     G. Communications Between and Amongst Defendants ...................... 1283
                     H. Common Group Associations of Defendants ............................ 1288
                        1. Classic Cup Dinners ............................................. 1288
                        2. Ingram's Magazine Meeting ....................................... 1289
                        3. HFMA Meeting .................................................... 1289
                     I. Motion to Strike ................................................... 1290
                 IV. GENERAL SUMMARY JUDGMENT STANDARDS .................................... 1292
                  V. ANALYSIS .............................................................. 1292
                     A. Sherman Act, 15 U.S.C. § 1 ........................................... 1292
                        1. Heartland's Styling of its § 1 Claim .............................. 1292
                        2. Standards of Law and Summary Judgment on a § 1 Claim .............. 1295
                        3. Analysis of Heartland's § 1 Claim ................................. 1298
                           a. Direct Evidence .............................................. 1298
                           b. Economic Motive .............................................. 1302
                           c. Circumstantial Evidence ...................................... 1303
                        4. Individual Defendants' Participation ............................ 1309
                           a. Aetna's Participation ........................................ 1309
                           b. Coventry's Participation ..................................... 1313
                           c. HCA Midwest's Participation .................................. 1315
                           d. Saint Luke's Participation ................................... 1317
                           e. Shawnee Mission Medical Center's Participation ............... 1319
                           f. Carondelet's Participation ................................... 1320
                        5. Conclusion—Sherman Act .......................................... 1321
                     B. Tortious Interference with a Prospective Business Relationship ..... 1322
                     C. Civil Conspiracy ................................................... 1325
                

                 VI. CONCLUSION ............................................................ 1325
                

I. INTRODUCTION

This matter comes before the court on defendants Aetna Health Inc. and Aetna Life Insurance Company's (collectively "Aetna's") motion for summary judgment (Does. 777, 778); defendants Coventry Health Care of Kansas, Inc., Coventry Health and Life Insurance Company, and SouthCare PPO, Inc.'s (collectively "Coventry's") motion for summary judgment (Does. 848, 852); and defendants Midwest Division, Inc. d/b/a HCA Midwest Division ("HCA Midwest"), Saint Luke's Health System, Inc. ("Saint Luke's"), Carondelet Health, St. Joseph Medical Center, St. Mary's Medical Center (collectively "Carondelet"), and Shawnee Mission Medical Center, Inc.'s ("Shawnee Mission Medical Center's") joint motion for partial summary judgment (Does. 834, 835).

The motions have been fully briefed¹ (Does. 833, 899, 901, 920, 921) and the court held oral argument on the motions on September 27, 2007.

The motions...