2 NC officials backing Asheville HCA lawsuit call new Brevard case 'serious,' 'courageous'

ASHEVILLE — Two top North Carolina officials who already have thrown their support behind a lawsuit against HCA Healthcare's 2019 purchase of Mission Hospital are calling a new antitrust lawsuit from the city of Brevard "serious" and "courageous."

N.C. Attorney General Josh Stein and State Treasurer Dale Folwell have each filed amicus briefs in the first HCA antitrust lawsuit out of WNC brought by Asheville community members in August, a case currently awaiting a decision in North Carolina Business Court.

Now they have each voiced similar concerns about the new antitrust case, filed by the city of Brevard June 3.

"Our office is aware of and closely following the city of Brevard’s antitrust lawsuit against HCA," Stein spokesperson Nazneen Ahmed said. "These allegations are especially serious because anticompetitive conduct in health care can hurt North Carolinians’ access to affordable, quality care. Our office will continue its work to protect our state’s patients."

Folwell called elected officials in the Transylvania County city "courageous" for taking legal action but said he was saddened by the toll the 2019 purchase had taken on WNC residents.

The history of WNC's antitrust action against HCA Healthcare:

• HCA, Mission hit with 2nd WNC antitrust suit in a year, this one from a Transylvania city

• HCA/Mission hit with anti-trust lawsuit, accused of exorbitant prices, declining quality

• HCA anti-trust lawsuit filed in Asheville gets extension, new deadlines

• HCA: Asheville residents' anti-trust lawsuit is an 'end-run' around Mission hospital sale

• AG Stein says he 'will not hesitate to act' if abuses in lawsuit against Mission are true

• NC Treasurer files interest in HCA anti-trust suit; plaintiffs reiterate concerns

• AG Stein hears WNC leaders on Mission sale fallout, says he's eyeing merger law changes

"I grieve for the people of Western North Carolina as we're coming up on the third birthday of this transaction," he said. "All we're seeing is more evidence of lower quality, lower access and higher cost of health care."

The Brevard v. HCA lawsuit proposes class action for "unlawful restraint of trade and monopolization" and seeks damages and relief through a jury trial, noting Mission now holds a "monopoly market share" — 70% or more — in seven counties: Yancey (90.9%), Madison (90%), Buncombe (86.6%), Mitchell (85.4%), Transylvania (78.7%), McDowell (76.4%) and Macon (74.7%).

Transylvania Regional Hospital is in Brevard, the county's seat, and is one of five hospitals in WNC owned by HCA Healthcare and in Mission Health regional system.

“Our lawsuit is being brought at a time when providing affordable health care insurance plans for working families and governmental employees, such as firefighters, police, and teachers, and controlling health care costs have been top priorities for the city of Brevard and members of the proposed class, and the business communities they serve,” Brevard Mayor Maureen Copelof said in a June 3 news release.

The city operates a self-funded health insurance plan for its employees and their families and wants to "represent a class of similarly situated North Carolina health insurance plans, including self-funded and commercial insurers," according to the news release.

“We hope that this lawsuit will begin to compensate us for overpaying for health care, and bring an end to the harm HCA has caused to Brevard and other communities in Western North Carolina,” Brevard Mayor Pro Tempore Gary Daniel said in the release.

Outside of their separate amicus briefs, both officials in recent months have been involved in issues related to HCA's 2019 purchase of Mission Hospital.

According to a Cornell Law School definition, "An amicus curiae brief ... brings to the attention of the court relevant matter not already brought to its attention by the parties may be of considerable help to the court."

Folwell in February endorsed a report alleging HCA's hospitals and others in WNC are not complying with a year-old federal regulation requiring prices to be clear and easily accessible.

He also expressed support for proposed N.C. House Bill 1039, which aims to protect families from "unfair tactics in debt collection."

"It's meant to stop punishing people because of health care billing," Folwell said, "and not only stop punishing them but stop weaponizing their credit scores because of things associated with health care billing."

HB 1039 is also known as the "Medical Debt De-Weaponization Act" and passed first reading May 26.

More: Mission nurse on HCA fallout during merger hearing: Shocked and horrified

During a recent circuit in which he visited several North Carolina communities with large hospital systems, including Buncombe, Stein heard former HCA doctors, current nurses, local elected officials and community members on how they were impacted by the 2019 sale.

Stein said he's searching for new legislative options to keep corporations in check when it comes to big mergers and/or acquisition.

"Between 2000 and 2016, North Carolina had the fifth-highest number of rural hospital mergers in the nation," he said April 28. " I want to underscore that I’m frustrated with the state of North Carolina’s law as it relates to my authority to conduct reviews like this of hospital conglomerations. The ability for me to review these transactions is both inadequate and inconsistent."

Mission and HCA spokesperson Nancy Lindell, speaking on the recent Brevard lawsuit, said the company had hoped a recent meeting with Copelof "would be the beginning of a thoughtful and ongoing dialog about healthcare in the city of Brevard and the broader Transylvania County region."

Now, Lindell said, HCA will turn its attention to "vigorously defending" the lawsuit in the Western North Carolina U.S. District Court where it was filed.

Andrew Jones is Buncombe County government and health care reporter for the Asheville Citizen Times, part of the USA TODAY Network. Reach him at @arjonesreports on Facebook and Twitter, 828-226-6203 or arjones@citizentimes.com. Please help support this type of journalism with a subscription to the Citizen Times.

This article originally appeared on Asheville Citizen Times: State officials voice thoughts on Brevard v. HCA lawsuit