Before joining UC Hastings, Professor Greaney was the Chester A. Myers Professor of Law and Director of the Center for Health Law Studies at Saint Louis University School of Law. He has written extensively on topics involving health law and policy, antitrust law, and health care financing and is co-author of the nation’s leading health law casebook and hornbook. He has testified several times before the Judiciary Committee of the U.S. House of Representatives and consulted for the FTC, U.S. Department of Justice and state attorneys general on health law enforcement issues. Prior to joining the SLU Law faculty, he served as an Assistant Chief in the Department of Justice, Antitrust Division, specializing in health care antitrust litigation, and completed a visiting professorship at Yale Law School. He has also been a Fulbright Fellow studying European Community competition law in Brussels, and has been a visiting scholar at Université Paris Dauphine in Paris, Seton Hall University, and the University of Minnesota. Professor Greaney was named Jay Healy Health Law Professor of the Year by the American Society of Law, Medicine and Ethics in 2007. He received his B.A magna cum laude from Wesleyan University and his J.D. from Harvard Law School.
Areas of Expertise (4)
Affordable Care Act (Aca)
Jay Healy Award
Health Law Teacher of the Year 2007, American Society of Law, Medicine and Ethics
Thompson & Mithcell Award
Best Faculty Publication, 1989, 2004, 2011, 2013 Honorable Mention, 1990, 1997, 2006, 2007
Harvard Law School: J.D.
Honors: Ames Prize for the Best Brief in First Year Class
Wesleyan University: B.A.
Honors: Phi Beta Kappa, High Honors, Vanderbilt Prize as Outstanding Student in the Social Sciences
- Chester A. Myers Professor of Law : Saint Louis University School of Law
- Co-Director, Center for Health Law Studies : Saint Louis University School of Law
Media Appearances (4)
Anthem's Pursuit of Cigna Still in Play, but Faces Huge Hurdles
Professor Thomas Greaney, co-director of the Center for Health Law Studies at St. Louis University School of Law, said convincing the appeals court that the lower court erred will be tough, because "it wrote a pretty good opinion."...
Court Blocks Aetna-Humana Deal: The Mega-Mergers Meet The Trump Administration Next
Health Affairs Blog
Big Insurance was dealt a significant blow on Monday, January 23. A federal judge in Washington D.C. ruled in favor of the Department of Justice (DoJ) and blocked the proposed $37 billion merger of Aetna and Humana because it would have anti-competitive effects in violation of federal antitrust laws. All eyes are now on DoJ’s parallel case (also proceeding apace in D.C., but before a different federal judge), which aims to stop an even larger, $48 billion merger of two more mega-insurers: Anthem (the largest member of the Blue Cross network) and Cigna...
Post-ACA Landscape Raises Stakes for Insurer Megamergers
In that case, “You'd think that the (court's) analysis should be the same or even more vigilant because you're going to have scenarios in which consumers are going to be shopping around for the best plans and deals from hospitals because they are going to have copays and responsibilities and rely heavily on HSAs,” Thomas Greaney, a St. Louis University law professor and former assistant chief in charge of healthcare antitrust enforcement at the Justice Department...
FTC May Not Take No for an Answer After Surprising Hospital Merger Defeat
“This case goes contrary to FTC advocacy and success in other cases, so I'm sure they don't want this to stick,” said Thomas Greaney, a former assistant chief in charge of healthcare antitrust enforcement at the Justice Department, who is now co-director of the Center for Health Law Studies at St. Louis University School of Law. “I just think this opinion standing on the books is not a good one for them.”...
Selected Articles (5)
Navigating Through the Fog of Vertical Merger Law: A Guide to Counselling Hospital-Physician Consolidation Under the Clayton ActUniversity of Washington Law Review
Greaney, Thomas L.; Ross, Douglas
2016 Lawyers assessing legality under the antitrust laws of hospital acquisitions of physician practices face a quandary. The case law is sparse, federal enforcement guidance outdated, and academic input conflicting. Applying these muddled standards in the rapidlyevolving health care sector only magnifies the uncertainty. While most transactions will be competitively neutral or beneficial, rapidly evolving market conditions causing integration between hospitals and physicians present opportunities for consolidations that may harm consumer interests. Indeed, given the highly concentrated structure of many hospital markets in the nation, preemptive acquisitions of physician practices may be a tempting strategy for some to undermine competition. This Article offers guidance by analyzing potential theories of competitive harm and addressing factual elements necessary to establish a violation of antitrust merger law.
Medicare Advantage, Accountable Care Organizations, and Traditional Medicare: Synchronization or Collision?Yale Journal of Health Policy, Law, and Ethics
Greaney, Thomas L.
2015 Despite its size and immense influence over health care in America, Medicare today is no monolith. It is comprised of three distinct payment programs though which it provides services to beneficiaries: "traditional," fee-for-service (FFS) Medicare; Medicare Advantage (MA); and the Medicare Shared Savings and Pioneer accountable care organizations (ACO) programs.
Competition Policy after Health Care Reform: Mending Holes in Antitrust Law's Protective NetJournal of Health Politics, Policy and Law
Greaney, Thomas L.
The Tangled Web: Integration, Exclusivity, and Market Power in Provider ContractingHouston Journal of Health Law and Policy
Greaney, Thomas L.
2014 Antitrust law often proclaims itself in such general standards that private parties on all sides simply do not know where they stand, and the courts are often no better advised on the proper disposition of the controversy. Some uncertainty is of course inevitable, but we should be cautious about expanding it to the point that the legal rule becomes incoherent.
Regulators as Market-Makers: Accountable Care Organizations and Competition PolicyArizona State Law Journal
Greaney, Thomas L.
2012 Of the many elements animating structural change under health reform, Accountable Care Organizations (ACOs) have drawn the greatest attention. The ACO strategy entails regulatory interventions that at once aim to reshape the health care delivery system, improve outcomes, promote adoption of evidence based medicine and supportive technology, and create a platform for controlling costs under payment system reform. Ambitious aims to be sure. Implementation, however, has proved a wrenching process. This article looks at the intersection of markets and regulation under the Affordable Care Act. Specifically, it analyzes regulatory interventions under the MSSP designed to foster commercial market competition. Assessing prospects for success, it advances several interrelated arguments. First, in fulfilling the regulatory task of implementing the MSSP, regulators needed to be vigilant to protect against the potential that ACOs may have adverse effects on private markets. It finds that because the Centers for Medicare and Medicaid Services (CMS) was overly preoccupied with Medicare program issues and hyper-sensitive to criticism from powerful hospitals, the agency missed an important opportunity in its implementing regulations to prevent exacerbation of provider market power. Because existing legal regimes, especially antitrust law, are severely constrained in their ability to deal with extant provider market power, regulation of ACOs requires a cross-platform regulatory approach that addresses market issues.