by
Astrid Fiano, DOTmed News Writer | February 05, 2010
Settlement with physicians group
The Federal Trade Commission has announced an agreement with a Colorado physicians group to settle charges of price-fixing, and to stop the group's alleged anti-competitive negotiating tactics against health insurers.
The FTC charged Roaring Fork Valley Physicians I.P.A., Inc., (Roaring Fork) of Glenwood Springs, CO, (an independent practice association representing around 80 percent of physicians in Garfield County, CO), with violating the FTC Act. According to the FTC complaint, about 85 different competing independent physicians and physician practice groups acted through Roaring Fork, which orchestrated agreements to fix prices with payers offering services in the area. The agreements allegedly involved refusing to deal with payers except on collectively agreed-upon terms; and facilitating/implementing agreements on price-related terms.
The FTC said the terms included demanding that contracts with insurers include a cost of living provision to raise reimbursement rates every year, and banning a commonly-used cost-lowering provision linking reimbursement rates to Medicare rates. The FTC alleged that the group's discouraging members from individually contracting with insurers significantly increased the bargaining power of the IPA. The activities resulted in unjustified increased consumer prices for physician services, the FTC said.
The FTC settlement prohibits Roaring Fork from collective price negotiations and from collectively refusing to deal with insurers. Roaring Fork must also terminate any contracts with insurers that were reached using price-fixing tactics, notify the FTC before acting in an agent capacity to communicating contract offers between physicians and insurers, and have agency review and approval of participation in any collaborative arrangement with physicians.
The FTC notes that issuance of a complaint is not a finding or ruling that the respondent has violated the law, and a consent agreement does not constitute an admission of law violation.
Adapted in part from a FTC press release.
Read more details:
http://www.ftc.gov/opa/2010/02/roaringfork.shtm
http://www.ftc.gov/os/caselist/0610172/index.shtm
