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In an effort to prevent anticompetitive behavior in the American healthcare marketplace, the Federal Trade Commission (FTC) has recently turned its attention to the rise in hospital mergers facilitated through the use of Certificate of Public Advantage (COPA) laws.

COPAs allow state agencies to approve proposed mergers among healthcare facilities following a satisfactory determination that the advantages of the merger outweigh the anticompetitive effects of consolidation in the healthcare marketplace. Typically, the state departments of health are charged with supervising and regulating mergers exercised under COPAs.

The FTC asserts that COPAs function as a mechanism to shield hospital mergers from scrutiny under state and federal antitrust laws subject to state action doctrine. The FTC argues that hospital mergers granted pursuant to COPAs are destined to cause adverse effects in the marketplace, such as higher prices for patients seeking medical care, a decline in the quality of care rendered, and a reduced level of access to various medical services.

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