The court of appeals affirmed in part and reversed in part a judgment and remanded. The court held that a state’s use of a certificate of need system to limit the number of medical providers licensed to perform specialized services did not violate the Sherman Act.

Congress made certificate of need regimes part of the federal government’s national health planning policy in the National Health Planning and Resources Development Act of 1974 (NHPRDA). The NHPRDA conditioned federal funding on enforcement of certificate of need regimes as part of the congressional effort to reduce health-care inflation and achieve an adequate supply and distribution of health resources.