Document ID: ./input/supremecourt_opinions/opinions/14pdf/13-534_19m2.pdf
Page Number: 2.0

2 

NORTH CAROLINA STATE BD. OF DENTAL
EXAMINERS v. FTC 

Syllabus
 

all respects. 

Held:  Because a controlling number of the Board’s decisionmakers are 
active market participants in the occupation the Board regulates, the
Board can invoke state-action antitrust immunity only if it was sub-
ject to active supervision by the State, and here that requirement is 
not met.  Pp. 5–18.

(a) Federal antitrust law is a central safeguard for the Nation’s free
market  structures.    However,  requiring  States  to  conform  to  the 
mandates of the Sherman Act at the expense of other values a State
may  deem  fundamental  would  impose  an  impermissible  burden  on
the  States’  power  to  regulate.    Therefore,  beginning  with  Parker  v. 
Brown,  317  U. S.  341,  this  Court  interpreted  the  antitrust  laws  to
confer  immunity  on  the  anticompetitive  conduct  of  States  acting  in
their sovereign capacity.  Pp. 5–6.

(b) The  Board’s  actions  are  not  cloaked  with  Parker  immunity.    A 
nonsovereign actor controlled by active market participants—such as
the Board—enjoys Parker immunity only if “ ‘the challenged restraint 
. . .  [is]  clearly  articulated  and  affirmatively  expressed  as  state  poli-
cy,’  and  . . .  ‘the  policy  . . .  [is]  actively  supervised  by  the  State.’ ” 
FTC v. Phoebe Putney Health System, Inc., 568 U. S. ___, ___ (quoting 
California Retail Liquor Dealers Assn. v. Midcal Aluminum, Inc., 445 
U. S. 97, 105).  Here, the Board did not receive active supervision of 
its anticompetitive conduct.  Pp. 6–17.

(1) An entity may not invoke Parker immunity unless its actions 
are an exercise of the State’s sovereign power.  See Columbia v. Omni 
Outdoor  Advertising,  Inc.,  499  U. S.  365,  374.    Thus,  where  a  State 
delegates control over a market to a nonsovereign actor the Sherman
Act confers immunity only if the State accepts political accountability
for  the  anticompetitive  conduct  it  permits  and  controls.    Limits  on 
state-action immunity are most essential when a State seeks to dele-
gate its regulatory power to active market participants, for dual alle-
giances are not always apparent to an actor and prohibitions against
anticompetitive  self-regulation  by  active  market  participants  are  an
axiom  of  federal  antitrust  policy.    Accordingly,  Parker  immunity  re-
quires that the anticompetitive conduct of nonsovereign actors, espe-
cially those authorized by the State to regulate their own profession,
result  from  procedures  that  suffice  to  make  it  the  State’s  own. 
Midcal’s two-part test provides a proper analytical framework to re-
solve  the  ultimate  question  whether  an  anticompetitive  policy  is  in-
deed  the  policy  of  a  State.  The  first  requirement—clear  articula-
tion—rarely will achieve that goal by itself, for entities purporting to 
act  under  state  authority  might  diverge  from  the  State’s  considered
definition of the public good and engage in private self-dealing.  The 
second  Midcal  requirement—active  supervision—seeks  to  avoid  this