New healthcare antitrust enforcement guidelines being completed by federal law enforcement agencies likely will create an antitrust "safety zone" for certain types of provider networks, sources familiar with the guidelines told MODERN HEALTHCARE.
The sources, who requested anonymity, said the new guidelines, which will supplement last fall's healthcare antitrust enforcement guidelines, likely will be released by Sept. 15.
The guidelines will address what the Justice Department and the Federal Trade Commission are calling "multiprovider networks," which may include hospitals, physicians and other providers, according to the sources. Therefore, the guidelines would cover physician-hospital organizations, which are proliferating around the country.
A distinction is expected to be made in the guidelines between exclusive and nonexclusive networks, according to the sources. Exclusive networks are closed to all but participating providers and may restrict a provider's access to other networks. Nonexclusive networks are open to all providers who meet the networks' participation criteria and typically don't limit access to other networks. The guidelines would treat exclusive networks less favorably than nonexclusive networks.
The sources also said they expect the guidelines for provider networks, although helpful to providers, to be narrow in scope, giving the two agencies maximum flexibility to review new types of networks being developed in many markets.
Gail Kursh, chief of the professions and intellectual property section of the Justice Department's antitrust division, confirmed that new guidelines are in the works. She declined to discuss the focus of the guidelines.
Last September, the Justice Department and the FTC issued the first-ever set of healthcare antitrust enforcement guidelines, which created six so-called "safety zones" for provider business arrangements (Sept. 20, 1993, p. 3). However, none of the safety zones addressed networks of different types of providers, and healthcare industry groups have been lobbying for a network safety zone ever since.