As acknowledged by an opinion issued by the California Attorney General’s office, the Supreme Court’s decision in North Carolina State Board of Dental Examiners v. Federal Trade Commission caught state governments by surprise. Most states have allowed their licensing boards to operate under the assumption that industry members were protected from antitrust suits under the state action immunity doctrine. The California Attorney General outlined some dramatic actions that she felt her State would need to consider. In response to warnings given by the Oklahoma Attorney General, Governor Mary Fallin issued an executive order recognizing that her state industry boards lacked active supervision and therefore, all licensure and prohibition actions were to be submitted to the Attorney General for review and written analysis of possible violation of law. But despite the surprise that state officials might express, there are voices advising that industry boards have long done more damage to competition than good for consumer protection. (See the hyperlinks provided below.) Consequently, supporters of open and competitive markets are forecasting a spike in lawsuits brought against industry boards.

The suppression of preneed by industry boards was once very pervasive, and the fruit of those actions still exist in the form of rules and ‘informal positions’. It has been more than a decade since this author appeared before one of those industry boards on behalf of a client challenging a position regarding proceeds from a guaranteed preneed contract. The board’s position had a very detrimental impact on the sale of preneed contracts, and nothing could be done to change the board’s collective minds. However the board and the client agreed to submit the issue for an independent review by the Attorney General’s office. The board was advised by an associate Attorney General, who framed the board position in a request to her boss. This author then presented the arguments for how the position was arbitrary and a restraint of trade. However, the Attorney General’s office applied a rather unique interpretation of ‘independent review’, and assigned the opinion request to the same attorney that represented the board. The FTC would not tolerate such behavior under the new active supervision guidelines. And, any board action taken in reliance on such a rule or position will be just as suspect.

(Boards Behaving Badly; Cartels By Another Name; The Antitrust Implications of Licensed Occupations; and Prepared Statement of the Federal Trade Commission)

The Supreme Court’s recent decision in North Carolina Board of Dental Examiners v. Federal Trade Commission left states with a number of unanswered questions, including when a proposed regulation or discipline action would trigger a restraint of trade claim.  In December 2015, the US District Court in Texas addressed that issue in Teladoc, Inc. v. Texas Medical Board. The Court faced the question of whether actions taken by the Texas Medical Board violated the antitrust laws.

The Texas court focused on two types of evidence – lower costs and additional benefits- to analyze whether the actions of the Texas Medical Board to exclude Teladoc from providing services in Texas would likely harm competition.  The court did not require Teladoc to perform a detailed analysis of the actual impact of the Board’s actions on the market.  The court issued an injunction on Teladoc showing that it offered lower prices and greater convenience, and that the Board’s actions would destroy a business model.  Antitrust experts see the court’s ruling as an indication that courts are already beginning to follow the Supreme Court’s reasoning to encourage competition by making industry licensing boards more accountable for their actions.  (See the Antitrust Attorney Blog)

In its Active Supervision Guidelines, the Federal Trade Commission staff discusses how regulatory boards frequently act in an adjudicatory capacity by seeking to impose discipline on a licensee or by seeking to enjoin an unlicensed individual. While such actions may have an anti-competitive effect, those actions will not necessarily expose the board members to personal anti-trust liability if the Board’s actions are ministerial in nature, are expressly authorized by statute, or involve a reasonable restraint of competition. As an example of reasonable competition restraint, the FTC staff described how regulatory boards can sue to prohibit deceptive advertising. As an example of a ministerial proceeding, the FTC staff described how a board might revoke a license because the licensee failed to provide documentation required by statute. For another example, the Guidelines reference where a state statute defines functions that require a license, and also authorize the regulatory board to enjoin an unlicensed individual from performing those functions.

When the members of the Missouri State Board of Embalmers and Funeral Directors ran afoul of the Federal Trade Commission ten years ago, the Board sought to enjoin an unlicensed individual from selling caskets. The Board relied upon a regulation, rather than a statute, as the authority for the functions that could not be performed by an unlicensed individual. Putting aside the “clear articulation” prong required by California Retail Liquor Dealers Assn. v. Midcal Aluminum, Inc., 445 U.S. 97 (1980), the Missouri State Board would have been required to demonstrate the following actions were taken by the either the Division of Professional Registration or the Missouri Attorney General’s Office before the lawsuit was filed:

(i) reviewed the evidentiary record created by the regulatory board;
(ii) supplemented the evidentiary record if and as appropriate;
(iii) undertook a de novo review of the substantive merits of the proposed disciplinary action, assessing whether the proposed disciplinary action comports with the policies and standards established by the state legislature; and
(iv) issued a written decision that approved, modified, or disapproved the disciplinary action proposed by the regulatory board.

In the case of a proceeding to discipline a licensee, the FTC staff suggests that that a disciplinary action taken by a regulatory board affecting a single licensee will typically have only a de minimis effect on competition. However, a pattern or program of disciplinary actions by a regulatory board affecting multiple licensees could have a substantial effect on competition.

Last week we posted the Federal Trade Commission’s Active Supervision Guidelines for industry boards. The Guidelines set some substantial standards for the independent state agency or attorney general that provides supervision over an industry board. When that agency or attorney fails to satisfy the supervision requirements, the industry members are exposed to personal liability when they pass regulations or pursue litigation that restrains trade regardless of whether the actions are consistent with a statue or a clearly articulated state policy. Until the North Carolina Dental Board decision, states felt that so long as the board action was consistent with restraints authorized by a state law or a clearly articulated state policy, a low level of supervision would suffice to provide their industry members the exemption from anti-trust litigation. In preparing the Guidelines, the FTC staff addressed those ‘low levels of supervision’ as a warning to states of what would fail to constitute active supervision:

The following do not constitute active supervision of a state regulatory board that is controlled by active market participants:

 The entity responsible for supervising the regulatory board is itself controlled by active market participants in the occupation that the board regulates. See N.C. Dental, 135 S. Ct. at 1113-14.
 A state official monitors the actions of the regulatory board and participates in deliberations, but lacks the authority to disapprove anticompetitive acts that fail to accord with state policy. See Patrick v. Burget, 486 U.S. 94, 101 (1988).
 A state official (e.g., the secretary of health) serves ex officio as a member of the regulatory board with full voting rights. However, this state official is one of several members of the regulatory board and lacks the authority to disapprove anticompetitive acts that fail to accord with state policy.
 The state attorney general or another state official provides advice to the regulatory board on an ongoing basis.
 An independent state agency is staffed, funded, and empowered by law to evaluate, and then to veto or modify, particular recommendations of the regulatory board. However, in practice such recommendations are subject to only cursory review by the independent state agency. The independent state agency perfunctorily approves the recommendations of the regulatory board. See Ticor, 504 U.S. at 638.
 An independent state agency reviews the actions of the regulatory board and approves all actions that comply with the procedural requirements of the state administrative procedure act, without undertaking a substantive review of the actions of the regulatory board. See Patrick, 486 U.S. at 104-05.

Ten years ago, the members of the Missouri State Board of Embalmers and Funeral Directors were defendants in anti-trust litigation brought first by the Institute for Justice and then by the Federal Trade Commission. That state board sought to enforce their funeral directing licensure regulation against an individual selling caskets. At that time, the State Board was accountable to the Division of Professional Registration, and was advised by the Missouri Attorney General’s office on an on-going basis. However, the State of Missouri failed the State Board on both prongs of the Active Supervision Guidelines. The Board was allowed to pursue trade restraining actions which were not defined by statute or articulated state policy, and the supervising entity/individual failed to provide, and document, a substantive review.

In this past week’s Memorial Business Journal, the NFDA’s general counsel offered insight on the FTC’s guidelines to state supervision of industry regulatory boards.  In a decision that rocked state boards comprised of industry members, the United States Supreme Court affirmed a decision that had held members of the North Carolina Dental Board subject to antitrust liability.  The eventual impact of that decision was difficult to predict because the North Carolina Dental Board argued that it had sovereign immunity without addressing the supervision provided by the State of North Carolina.  In response to requests from states, the Federal Trade Commission issued supervision guidelines last October (FTC Staff Guidelines on Active Supervision of State Regulatory Boards Controlled by Market Participants).

The NFDA general counsel suggests that the FTC Active Supervision guidelines would leave states three courses of action to protect industry boards from antitrust liability: 1) change the composition of the industry board; 2) convert the regulatory board to an advisory board; or 3) create a regulatory oversight body or person.  But, an attorney for a regulatory watchdog organization recently provided our office suggestions and information that shed light on how industry boards already have ‘supervisory bodies’ that are simply failing to meet the FTC’s guidelines.  A board’s supervisory body need not satisfy the guidelines with regard to each regulation or decision, but rather with regard to actions that involve credible assertions of anti-competitive or antitrust consequences.  Taking the Missouri State Board of Embalmers and Funeral Directors as an example, the Board is staffed and ‘supervised’ by the Division of Professional Registration.   The Division personnel would not have to ‘rise’ to the FTC Active Supervision guidelines on every rule proposed or discipline proceeding instituted, but rather only on actions where there has been a credible assertion of antitrust implications.

To illustrate that suggestion, we wrote last year regarding the Missouri Funeral Directors Association raising the North Carolina Dental Board decision in the context of the State Board’s examination procedures.  It was never explained how the examination procedures or the proposals for future audits suppress competition in favor of all or part of the funeral industry.  Assume instead that the Association made a credible claim that the exam procedures had antitrust implications.   If the State Board then proceeded to promulgate the examination rule without the Division staff satisfying the FTC Active Supervision guidelines, the State Board members would then open themselves up to personal liability for an antitrust violation.

If there is a current context that may be ripe for the application of the FTC Active Supervision guidelines, it may be the restriction of insurance funded products by state funeral boards.  We will explore that issue in further detail in a future post.

*”Reprinted with permission from the February 4, 2016 issue of the Memorial Business Journal. To subscribe please call 609-815-8145.”

The Missouri Funeral Trust now faces the predicament we predicted a few months ago (The MFT’s Catch 22). The Court recently granted the State’s motion to dismiss, and dropped the State Board from the lawsuit. The main motivation for the lawsuit was probably to gain leverage in bringing a long and frustrating audit to a conclusion. However, the lawsuit has not only fueled existing concerns, but also raised new issues (such as whether litigation expenses are being paid out of the program’s trust). A week following the dismissal, the master trust program filed motions to protect its documents and client list, and to compel production of documents and information by the remaining defendant. Those pleadings counter CFL Pre-Need’s motions to compel the master trust program to respond to its own requests for documents and information. Meanwhile, the State Board watches on, wondering whether protracted litigation over discovery issues is costing funeral homes and consumers.

In September we posted about a regulation proposal that sought to define the role of a sub-committee of the Missouri State Board of Embalmers and Funeral Directors (Missouri’s Financial Examination Committee: What Role?).   While the Board eventually gave its staff instructions to revise that proposal, the regulation has yet to resurface.  Instead, the Staff Recommendations include suggested actions that the Examination Committee may take.

The Recommendations contemplate that a seller could submit to the Examination Committee a plan to resolve cited exceptions over a period of up to 18 months.  Or that the Examination Committee could offer direction to the seller on how to resolve the exceptions over a period of up to 18 months, unless special circumstances exist.  All at the Examination Committee’s discretion.   The concern that some industry members raised in September was that the Examination Committee had too much discretion, and that sellers were being pressured into resolutions that were not required by law.  The Recommendations would have the State Board delegate authority to the Examination Committee the authority to define compliance requirements to preneed sellers.

In a prior post we alluded to Missouri preneed sellers’ complaints about the examination process, and that the follow up process to the on-site review has been unnecessarily burdensome.  Subsequent to the examiner’s departure from the funeral home, the seller received an exception list of missing contracts or documents, which the seller can often quickly locate.  However, the examination report will typically request the seller to make copies of the missing documents or contracts, and forward the documents to the State Board office.  As part of the Staff Recommendations, a seller would be required to affirm that it has provided the Board with copies of all requested preneed contracts.  While the Staff Recommendations cite Section 436.420 as authority for requiring the copying of contracts, Section 436.470 is the authority for examinations, and that language requires the seller to provide the examiner access to all preneed books and records.  If the examiner concludes the on-site review without inquiring about contracts or documents that he or she did not find, then the reliance on Section 436.420 is misplaced.  That financial examination handbook referenced by the Staff Recommendations should include an exit interview to avoid the burden of supplying documents and contracts that were in the seller’s records at the time of the on-site exam.

The Missouri State Board of Embalmers and Funeral Directors and the Board’s staff are engaged in an awkward exercise of establishing audit policies for the state’s preneed industry. The staff, employees of the Division of Professional Registration, must take the lead in making recommendations to the Board. The Board then must approve the recommendations, or instruct the staff on revisions, or make direct the staff to take a different direction.

However, the “Staff Recommendations” for the scope of Missouri’s second round of preneed examinations more resemble a request for an industry confidence vote than the start to a definitive road map for licensee compliance. A crucial regulation proposal that would define the recordkeeping requirements for sellers has been tabled to a later meeting. The Staff Recommendations allude to a procedural examination handbook, but only offer an update as to the status of such a handbook by the “Fall 2016”. As a consequence, the Staff Recommendations offer only a few concrete issues for Board approval.

One issue is whether a seller’s examination should include a review of all preneed contracts sold since the last examination. Some industry representatives, including this author, have suggested that the examination process allow for a sampling of contracts. But, at the Board’s December meeting, the staff included testimony from an examiner with the Missouri Department of Insurance. The testimony was given with the purpose to demonstrate that insurance companies have far more comprehensive filings (than do funeral homes) that assist the regulator to assess the risk of company failure. That testimony elicited questions and comments from industry members regarding the failure of that system to prevent the collapse of Lincoln Memorial Life. We did not find the Department of Insurance testimony persuasive for the fact that SB1 did not make the solvency of the seller funeral home a factor. The intent of the statute is to ensure the consumer funds are available regardless of the fate of the funeral home.

We agree with the staff’s comments that some sellers have too few preneed transactions to make a sampling review statistically reliable. But the question some sellers ask is what does the 100% review entail. If the seller’s first examination did not result in any exceptions for contract form compliance or completion issues (proper signatures and service descriptions), then why must all contracts be reviewed for those same issues. Why not a sampling as to those areas of review?

The Staff Recommendations do provide for a sampling review of ‘other active and fulfilled preneed contracts’. While some industry representatives will complain about any review of fulfilled contracts, we see the need for a review of at least a sampling of such contracts. But, the sampling review of fulfilled contracts is one example of where an exam procedures handbook could help alleviate industry concerns. Missouri funeral homes might be more receptive to the financial examination if the staff first defined the procedures.

When the Missouri State Board of Embalmers and Funeral Directors meet on January 6th, the main topic of discussion will be the scope of the next round of preneed financial examinations.   With the passage of Senate Bill No. 1 in 2009, the State Board was given the responsibility of conducting a preneed examination of each preneed seller once every five years.  With an exception or two, the first round of examinations has been completed.  The examination process was a work in progress for both the Board staff and preneed sellers, and not without controversy.

The staff recommendation to the State Board for Round 2 can be found at the end of the January 6th agenda.  We will explore some of the staff recommendations over the next few days.