Opinion · Court of Appeals for the Third Circuit

Brokerage Concepts v. US Healthcare Inc (Part II)

Brokerage Concepts v. US Healthcare Inc (Part II), 140 F.3d 494 (3d Cir. 1998)

Type
Opinion
Court
Court of Appeals for the Third Circuit
Jurisdiction
Federal
Date
1998-04-02
Topic
bankruptcy

holding that plaintiff failed to state an extortionate predicate act because plaintiff had no pre-existing right to be an approved provider, and thus free of economic fear | stating that section 1964(c) sets forth the "standing requirement" applicable to suits brought under RICO | holding that a “plaintiff must prove . . . for prospective contracts, a reasonable likelihood that the relationship would have occurred but for the interference of the defendant” (citing Pelagatti v. Cohen, 536 A.2d 1337, 1343 (Pa. Super. 1988) | holding that a “plaintiff must prove . . . for prospective contracts, a reasonable likelihood that the relationship would have occurred but for the interference of the defendant” (citing Pelagatti v. Cohen, 536 A.2d 1337, 1343 (Pa. Super. 1988) | recognizing "fear of economic loss is a driving force of our economy that plays an important role in many legitimate business transactions" | explaining that § 1964(c) sets forth the “standing requirement” applicable to suits brought under RICO | stating that the burden is on plaintiff to define the relevant market | inquiring whether an injury is “more appropriately attributable to an intervening cause that was not a predicate act under RICO.” | rejecting as impermissibly narrow a single-brand market “consisting solely of U.S. Healthcare members with prescription drug benefits” | stating the "logical assumption that [a pharmacy] considers members of other prescription plans, or uninsured persons, completely interchangeable with [privately insured] members." | addressing section 1964(c)'s proximate cause requirement in the context of standing analysis | noting that, in the wake of Kodak, it was possible that “a single brand market may be considered the relevant market where a legitimate class of consumers is locked in to purchasing a non-interchangeable tying product in a derivative market due to high switching costs” in the foremarket | addressing section 1964(c)’s proximate cause requirement in the context of standing analysis | declining to decide whether a tortious interference plaintiff needs to allege independently actionable conduct in order to defeat the competitor’s privilege, but noting that the Restatement (Second) of Torts defines “wrongful means” to include “fraud” | finding claim- of-right defense still applied where threatened conduct concerned an “unrelated market” | cross-applying Enmons while being “mindful” of earlier cases such as Agnes | defendant did not violate mail fraud statute by seeking audit of plaintiff because plaintiff knew defendant's "true motivation" for seeking audit | "[D]efendant's heavy-handed business tactics, . . . while relevant to a tortious interference claim, cannot be made to fit within the statutory and doctrinal constraints of the mail and wire fraud statutes." | defendant did not violate mail fraud statute by seeking audit of plaintiff because plaintiff knew defendant’s “true motivation” for seeking audit | when bringing a rule of reason tying claim, the plaintiff has the burden of showing the tie “unreasonably restrained competition in the tied product market” | In cases involving the use of economic fear, “a defendant is not guilty of extortion if he has a lawful claim to the property obtained.” | portion of instructions invited the jury to use impermissible factors, and, given the focus of the trial evidence, "such infection almost certainly occurred" | “Product market definition turns on the existence of close substitutes for a particular product, not on the ability of any particular consumer to switch effortlessly to such substitutes.” | Healthcare insurance company’s refusal to include pharmacy in provider network because pharmacy failed to accept conditions of inclusion constitutes “an example of hard bargaining rather than extortion.” | “The limitation we apply is that set forth in Enmons: that a defendant is not guilty of extortion if he has a lawful claim to the property obtained.” | "Product market definitio

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