(b) No Act of Congress shall be construed to invalidate, impair, or supersede any law enacted by any State for the purpose of regulating the business of insurance, or which imposes a fee or tax upon such business, unless such Act specifically relates to the business of insurance: Provided, That after June 30, 1948, the Act of July 2, 1890, as amended, known as the Sherman Act, and the Act of October 15, 1914, as amended, known as the Clayton Act, and the Act of September 26, 1914, known as the Federal Trade Commission Act, as amended [ 15 U.S.C. § 41 et seq.], shall be applicable to the business of insurance to the extent that such business is not regulated by State Law.Proctor v. State Farm Mutual Auto. Ins. Co., 406 F.Supp. 27 (D.D.C. 1975), aff'd, 561 F.2d 262 (D.C. Cir. 1977), vacated and remanded for further consideration in light of Group Life Health Ins. Co. v. Royal Drug Co., 440 U.S. 205, 99 S.Ct. 1067, 59 L.Ed.2d 261 (1979), 440 U.S. 942, 99 S.Ct. 1417, 59 L.Ed.2d 631 (1979) ( "Proctor I"), on remand, [1980-81] Trade Cases (CCH) ¶ 63,591 (D.D.C. 1980) ("Proctor II"). Appellants attack the District Court's decision primarily on the ground that the McCarran Act antitrust exemption applies to neither the horizontal nor the vertical practices challenged in this case because they do not constitute the "business of insurance."

Further, no court which has examined the antitrust implications of insurance provider agreements has used a per se approach. Proctor v. State Farm Mutual Insurance Co., 406 F. Supp. 27 (D.D.C. 1975) aff'd, 561 F.2d 262 (D.C. Cir. 1977), vacated and remanded, 440 U.S. 942, 99 S.Ct. 1417, 59 L.Ed.2d 631 (1979), on remand, 1980-2 Trade Cases ¶ 63,591 (D.D.C. 1980); DeBonaventura v. Nationwide Mutual Insurance Co., 419 A.2d 942 (Del.Ch. 1980) aff'd, 428 A.2d 1151 (Del. 1981); Chick's Auto Body v. State Farm Mutual Automobile Insurance Co., 168 N.J.Super. 68, 401 A.2d 722 (1979), aff'd per curiam, 176 N.J.Super. 320, 423 A.2d 311 (1981). See also Travelers Insurance Co. v. Blue Cross of Western Pennsylvania, 481 F.2d 80 (3d Cir.), cert. denied, 414 U.S. 1093, 94 S.Ct. 724, 38 L.Ed.2d 550 (1973).

Although the Supreme Court has cautioned that summary judgment should be used sparingly in complex antitrust litigation, Norfolk Monument Co. v. Woodlawn Memorial Gardens, Inc., 394 U.S. 700, 89 S.Ct. 1391, 22 L.Ed.2d 658 (1969); Poller v. Columbia Broadcasting System, 368 U.S. 464, 473, 82 S.Ct. 486, 491, 7 L.Ed.2d 458 (1962), these fundamental principles of civil procedure are equally applicable in antitrust litigation. Proctor v. State Farm Automobile Insurance Co., 561 F.2d 262, 275 (D.C. Cir. 1977), vacated on other grounds, 440 U.S. 942, 99 S.Ct. 1417, 59 L.Ed.2d 631 (1979) (significant evidence substantiating the theory of the complaint must be produced to defeat well supported motion for summary judgment); Merit Motors, Inc. v. Chrysler Corp., 417 F.Supp. 263, 266-67 (D.D.C. 1976), aff'd, 569 F.2d 666 (1977) (to defeat motion for summary judgment something more than naked assertions and broad generalities is required). This court, on review of a grant of summary judgment, will sustain the judgment only if a reasonable person could come to no factual conclusion other than that reached by the District Court.

Because it in no way limited the doctors' ability to deal with third parties, the agreement itself is not an agreement to boycott or coerce the plaintiffs to purchase the defendant's insurance. See Barry, 438 U.S. at 553, 98 S.Ct. at 2935-36; Klamath-Lake, 701 F.2d at 1287-88; Procter v. State Farm Mutual Automobile Insurance Co., 561 F.2d 262, 275 (D.C.Cir. 1977), vacated on other grounds, 440 U.S. 942, 99 S.Ct. 1417, 59 L.Ed.2d 631 (1979); Travelers Insurance Co. v. Blue Cross of West Pennsylvania, 481 F.2d 80, 84 (3d Cir.), cert. denied, 414 U.S. 1093, 94 S.Ct. 724, 38 L.Ed.2d 550 (1973); cf. Barber, Refusals to Deal Under the Federal Antitrust Laws, 103 U.Pa.L.Rev. 847, 876-77 (1955) (quoted in Joseph E. Seagram and Sons, Inc. v. Hawaiian Oke Liquors, Ltd., 416 F.2d 71, 77 (9th Cir. 1969), cert. denied, 396 U.S. 1062, 90 S.Ct. 752, 24 L.Ed.2d 755 (1970)). There is no "agreement to boycott, coerce or intimidate" within section 1013(b).

Pennsylvania courts have interpreted this clause to mean that officials in the executive branch of state government may not expend funds (and thus may not be ordered to do so by a state court) specifically appropriated by the state legislature for one purpose to carry out another program. Shapp v. Sloan, 480 Pa. 449, 391 A.2d 595 (1978), appeal dismissed sub nom. Thornburgh v. Casey, 440 U.S. 942 (1979); Ashbourne School v. Commonwealth Department of Education, 43 Pa.Commw. Ct. 593, 403 A.2d 161 (1979). Section 2 of H.B. 456 provides:

As the Royal Drug Court noted, the terms of the provider contracts were such that only pharmacies whose distribution costs were less than $2.00 could profitably participate in the plan, see 440 U.S. at 209, 99 S.Ct. at 1072, and the terms of Blue Shield's insurance policies would naturally encourage its insureds to patronize only participating pharmacies. The Supreme Court cited the decision of the Fifth Circuit in Royal Drug, 556 F.2d 1375 (1977), which it affirmed, as being "in conflict with" the decisions of the courts of appeals in Frankford Hospital v. Blue Cross, 554 F.2d 1253 (3d Cir.) (per curiam), cert. denied, 434 U.S. 860, 98 S.Ct. 186, 54 L.Ed.2d 133 (1977); Anderson v. Medical Service, 551 F.2d 304 (4th Cir. 1977) (mem.); and Proctor v. State Farm Mutual Automobile Ins. Co., 561 F.2d 262 (D.C. Cir. 1977), vacated and remanded mem., 440 U.S. 942, 99 S.Ct. 1417, 59 L.Ed.2d 631 (1979). See 440 U.S. at 208-09 n.2, 99 S.Ct. at 1072 n.2.

One of these cases was Royal Drug (defendants relied on the district court's holding in that case that the pharmacy agreements were the business of insurance. 415 F. Supp. 343 (W.D.Tex. 1976). Of the four other cases the defendants here found indistinguishable, two were singled out by the Supreme Court in Royal Drug as being "in conflict" with the Court's own interpretation of the phrase "business of insurance": Anderson v. Medical Service, 551 F.2d 304 (4th Cir. 1977) and Proctor v. State Farm Mutual Automobile Insurance Co., 561 F.2d 262 (D.C. Cir. 1977) ( vacated and remanded, 440 U.S. 942, 99 S.Ct. 1417, 59 L.Ed.2d 631 (1979)). Royal Drug, 99 S.Ct. 1072, n. 2.

Such conduct is in the economic self-interest of each individual insurance company and would redound to their benefit regardless of whether other companies chose to act similarly. See, e.g., Proctor v. State Farm, 561 F.2d 262, 267 (D.C. 1977), vacated and remanded on other grounds, 440 U.S. 942, 99 S.Ct. 1417, 59 L.Ed.2d 631 (1979). As many defendants point out in their briefs, to the extent that such cost savings are passed on to policyholders in the form of premium reductions, an insurer would stand to reap greater competitive advantage by concealing its cost saving programs than by sharing them.

It is sufficient in this branch of the opinion to say that such a pattern of statutory authority to regulate the business of insurance constitutes fully adequate state regulation for purposes of the McCarran-Ferguson Act, see, e.g. Crawford v. American Title Insurance Co., 518 F.2d 217 (5th Cir. 1975); Steingart v. Equitable Life Assurance Society, 366 F. Supp. 790 (S.D.N.Y. 1973); Transnational Insurance Co. v. Rosenlund, 261 F. Supp. 12 (D.Or. 1966), and the adequacy of the Virginia regulatory program has never been doubted. See, e.g., Proctor v. State Farm Mutual Automobile Insurance Co., 561 F.2d 262 (D.C. Cir. 1977), judgment vacated on other grounds, 440 U.S. 942, 99 S.Ct. 1417, 59 L.Ed.2d 631 (1979); Bartholomew v. Virginia Chiropractors Association, supra. C. Boycott, Coercion, Or Intimidation

" Id. In contrast, in Shapp v. Sloan, 391 A.2d 595 (Pa. 1978), appeal dismissed sub nom. Thornburg v. Casey, 440 U.S. 942 (1979), the Supreme Court of Pennsylvania upheld a statute requiring all federal funds to be deposited in the state's general fund and to be available for appropriation by the general assembly. After noting that from 1961 to 1975, the annual appropriations acts contained a provision that all moneys received from the federal government "shall be paid into the general fund and are hereby appropriated out of the general fund for purposes of the respective appropriations" and that the executive branch did not object to the provisions in the acts, id. at 599, the court observed: