BRADLEY A. CHICOINE, DR. BRADLEY A. CHICOINE, D.C., P.C., MARK A. NILES, NILES CHIROPRACTIC, INC., ROD R. REBARCAK, and BEN WINECOFF, on Behalf of Themselves and Those Like Situated, Appellants,
WELLMARK, INC. d/b/a WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA, an Iowa Corporation, and WELLMARK HEALTH PLAN OF IOWA, INC., an Iowa Corporation, Appellees. and STEVEN A. MUELLER, BRADLEY J. BROWN, MARK A. KRUSE, KEVIN D. MILLER, and LARRY E. PHIPPS, on Behalf of Themselves and Those Like Situated, Appellants,
from the Iowa District Court for Polk County, Michael D.
district court indefinitely stayed state antitrust
proceedings in favor of further proceedings in federal
multidistrict antitrust litigation. RULING ON MOTION VACATED;
REMANDED WITH DIRECTIONS.
L. Norris of Hawkins & Norris, P.C., Des Moines, and
Steven P. Wandro and Kara M. Simons of Wandro &
Associates, P.C., Des Moines, for appellants.
Hayward L. Draper, Ryan G. Koopmans, and John T. Clendenin
(until withdrawal) of Nyemaster Goode, P.C., Des Moines, for
Iowa chiropractors filed this class-action lawsuit against
Iowa's largest health insurer alleging it conspired with
nonparty competitors to fix prices, allocate markets, and
engage in other anticompetitive conduct in Iowa in violation
of the Iowa Competition Law. See Iowa Code ch. 553
(2015). The Iowa chiropractors allege that this
anticompetitive conduct has had the purpose and effect of
driving down chiropractor reimbursements to discriminatorily
defendants' motion, and over the plaintiffs'
objection, the district court stayed the case in its entirety
pending further proceedings in federal multidistrict
litigation (MDL) in Alabama brought under the federal
antitrust laws. See 15 U.S.C. §§ 1, 4
(2012). The Alabama MDL includes physicians, hospitals, and
other healthcare providers from around the country as
plaintiffs. As in the present case, the plaintiffs allege
conspiracies by the insurers to fix prices and allocate
markets. However, the MDL complaint alleges that the
conspiracies have had the effect of driving down all
healthcare provider reimbursements to artificially low
levels. One of the plaintiffs in the Alabama MDL is an Iowa
chiropractor and one of the defendants is Iowa's largest
interlocutory review, we conclude the district court abused
its discretion in staying the Iowa litigation pending further
proceedings in the Alabama MDL. Resolution of the Alabama
MDL, which is still in bellwether pretrial proceedings, could
take years, and although there is some overlap between the
two cases, there are also considerable differences in the
issues they present. Accordingly, we vacate the order staying
this action and remand for further proceedings.
Background Facts and Proceedings.
plaintiffs are Iowa chiropractors who treat patients enrolled
in health insurance plans offered or administered by the
defendants, Wellmark, Inc. d/b/a Wellmark Blue Cross and Blue
Shield of Iowa and Wellmark Health Plan of Iowa, Inc.
(collectively, Wellmark). Wellmark is an Iowa health
insurance corporation and a member of the national Blue Cross
and Blue Shield Association (BCBSA), a federation of over
thirty-five independent Blue Cross and Blue Shield (BCBS)
affiliates known as the Blues.
contracts with the plaintiffs and other healthcare providers
who agree to provide services to BCBS subscribers at or under
a discounted fee in exchange for being added to
Wellmark's network of preferred providers. Wellmark
shares this fee schedule and provider network with the
self-funded employee plans it administers in exchange for a
fee and with the other BCBS affiliates in exchange for their
promises to not use the BCBS trademark in Iowa and to share
their own fee schedules and provider networks with
Wellmark's subscribers (the BlueCard® Program)
seeking medical services in other states. See Mueller v.
Wellmark (Mueller II), 861 N.W.2d 563, 566-67
Prior Iowa Chiropractic Litigation.
involvement in the BlueCard® Program and its arrangements
with self-funded employee plans have been challenged by Iowa
chiropractors in related chiropractic litigation that has
come before our court four times. See Abbas v. Iowa Ins.
Div., N.W.2d (Iowa 2017); Wellmark, Inc. v. Iowa
Dist. Ct., 890 N.W.2d 636 (Iowa 2017); Mueller
II, 861 __ N.W.2d__ 563; Mueller v. Wellmark,
Inc. (Mueller I), 818 N.W.2d 244 (Iowa 2012).
For a brief summary of those cases, see Wellmark,
Inc., 890 N.W.2d at 638-42.
October 5, 2015, the plaintiffs filed a class-action petition
alleging Wellmark violated section 553.4 of the Iowa
Competition Law under the rule of reason. See Iowa
Code § 553.4 ("A contract, combination, or
conspiracy between two or more persons shall not restrain or
monopolize trade or commerce in a relevant
alleges Wellmark entered a combination or conspiracy with
potential competitors-the other BCBS affiliates and
self-funded employee plans Wellmark administers-to restrain
trade, commerce, and competition in the sale and purchase of
healthcare services in Iowa. The plaintiffs argue this
alleged conduct violates the Iowa Competition Law under the
rule of reason because "the anticompetitive consequences
of such conspiracy or conspiracies outweigh any
alleged restraints include agreements to
(a). . . artificially fix a lower price for chiropractic
services and to limit or exclude chiropractic coverage from
health plans offered by other potential competitors for
chiropractic services in Iowa[;]
(b). . . allocate territories and not to compete with each
other in those allocated territories[;]
(c) impose maximum fee schedules to which chiropractors must
agree with defendants, their co-conspirators, and with each
other in order to provide diagnostic and treatment ...