The California Medical Association has asked to be released from a 1979 consent decree that prohibits it from publishing physician fee information, contending the order restricts its ability to form an HMO.
The Federal Trade Commission in May granted a similar request by the American Academy of Orthopaedic Surgeons but on different grounds. In that case, the FTC allowed the academy to distribute fee information to influence Medicare policy.
"If it makes sense to rescind it for them, I think it would make sense to rescind it for everyone," said Catherine I. Hanson, vice president and general counsel for the California Medical Association.
Three other organizations-the American College of Obstetricians and Gynecologists, the Minnesota Medical Association, and the American College of Radiology-are under similar consent decrees, all dating from the late 1970s, the FTC said. None of the three has asked for a repeal.
The California Medical Association wants the FTC to clarify that the consent decree will not block its HMO subsidiary from paying physicians.
"Our interest is in having a managed-care organization, which the FTC and the (Clinton) administration indicated they want to promote," Hanson said.
The consent decree settled charges that the medical association effectively set prices by distributing a relative values study. The study assigned numerical values to procedures that physicians could convert into fee schedules, the FTC said.
In April 1985, the FTC modified the consent order to allow the association to participate in discussions on healthcare financing with government agencies and third-party payers, but it denied the group's request to be allowed to give its members relative value scales.
This year, the association established a subsidiary, California Advantage, which is recruiting physician investors for an HMO. The association contends that physician payment arrangements have evolved, eliminating the anti-competitive potential of giving fee schedules to doctors in managed care.
In the orthopedic surgeons case, the commission said Medicare's 1989 switch to a resource-based relative value scale to pay doctors warranted revoking the academy's 1976 order.
That allowed the academy to circulate information to third-party payers, its own members, and other nongovernmental organizations that influence Medicare policy.
Also, the academy said it wanted to participate in research on resource-based relative value scales. HHS and other organizations have sought information about the physician work component from medical societies.
But the commission cautioned that its unanimous action should not be construed as approval of using relative value scales to set prices.
The FTC will consider the California Medical Association's request after a 30-day comment period ending July 12.