What if I told you there was another antitrust case against a dominant healthcare system of record software vendor? There simply could not be another lawsuit between two payor software platforms, could there?

As of January 9, that is true, but not the players you think it might be. Infosys, a global consulting and IT services based out of India, issued a countercomplaint against Cognizant, another global consulting and IT services firm based out of India. These are two titans in the payer space, providing professional services for most payers nationwide. 

Cognizant (CST) did some light vertical integration in the 2010s by acquiring the two largest claims processing / payer software companies, QXNT and Trizetto, leading to control of 65% of the market. Infosys claims CST used their market weight to act anticompetitively, restricting the ability to integrate their software, poaching executives, and imposing restrictive NDAs and contract terms to prevent Infosys from effectively competing or developing alternative solutions like their Helix platform.

This is all in response to CST's initial claim that Infosys stole trade secrets by improperly creating a repository of test cases and developing integration tools for CST's software platforms. The case thus presents a complex intersection of intellectual property and antitrust law, with CST arguing it's simply protecting its proprietary technology while Infosys contends these IP claims are being weaponized to maintain monopoly power. 

The outcome could have significant implications for both innovation and competition in the healthcare payer software market, where many systems are still running on decades-old technology that CST acquired rather than developed and upstarts like Helix, Oscar Health's +Oscar, and others attempt to gain market share. It also has interplay with EHRs and other systems of record - the precedents set here around NDAs, interoperability requirements, and the balance between IP protection and anti-competitive behavior could influence how dominant healthcare IT vendors across all sectors manage access to their platforms.

For those counting at home, we have:
- An antitrust lawsuit against the largest acute care EHR in the country (Epic)
- An information blocking lawsuit against the largest skilled nursing facility EHR in the country (PointClickCare)
- An antitrust lawsuit against the largest vendor for payer software in the country (Cognizant)

Our winter of antitrust discontent continues.