The American Hospital Association last week confirmed what most antitrust observers have suspected for months: the AHA opposes federal legislation that would ease antitrust rules for physicians.
"We don't support the Hyde bill," said Richard Pollack, AHA executive vice president for federal relations. "We don't agree with the approach, and we don't think it's good policy."
Pollack said there's no need for federal legislation, particularly when the U.S. Justice Department and Federal Trade Commission are working on new antitrust guidelines that may give doctors what they want.
The Hyde bill refers to legislation introduced in February by Rep. Henry Hyde (R-Ill.) that would offer physicians significant relief from federal antitrust scrutiny. It would do that by prohibiting the Justice Department and the FTC from automatically considering certain physician network deals as illegal price-fixing schemes and instead would require the agencies to consider networks' actual effect on competition.
The threat of legislation that would tie their investigative hands and complaints from the American Medical Association prompted the agencies to begin developing more lenient antitrust guidelines for physician networks. The agencies are expected to release the guidelines this month.
Although the legislation passed the House Judiciary Committee in March, it's languishing in the full House and is not expected to pass anytime soon.
That makes it politically safe for the AHA to finally reveal its hand. For months, AHA executives consistently have said the association was staying neutral on the Hyde bill.
A source who requested anonymity said the AHA took a public stand of neutrality to avoid offending the AMA. The AMA and AHA recently entered a detente, joining forces on a number of fronts, including lobbying Congress to clarify the often-confusing federal fraud and abuse statutes.
"The AMA knew where we stood," Pollack said. "We agreed to disagree."
Pollack said the Chicago-based hospital trade group kept a low profile on the Hyde bill as a matter of strategy.
"We wanted to use our political capital wisely. The bill was not going anywhere this year," Pollack said. "We did not take it on in a big, visible way because there was no need to."
In addition, two large hospital organizations took up the cause, although Pollack said their involvement wasn't a factor in the AHA's low-profile approach. But he acknowledged that the organizations "share the same position and policy objectives" as the AHA on physician antitrust issues.
Last month, a coalition representing a cross section of the healthcare industry as well as employers sent all members of the House a letter urging them to oppose the Hyde bill.
"This legislation is unnecessary, anti-competitive and costly to consumers," the coalition said in its July 8 letter.
Signing onto the letter were the nation's two largest hospital alliances, Premier and VHA. The groups represent 3,000 hospitals combined.
VHA is not a member of the coalition but signed onto the letter. Premier is considered an active member of the coalition. Premier also is a member of the Healthcare Leadership Council, a broad-based healthcare advocacy group that's also a member of the coalition.
Premier's involvement is an indication that the newly formed alliance-created last year through the merger of the AmHS, Premier and SunHealth alliances-is willing to use its sizable clout to lobby Congress for policies favorable to its hospital membership.
When the three alliances merged, their executives indicated that becoming a lobbying organization wasn't one of their top priorities.
Premier spokeswoman Susan Nalepa confirmed that the alliance is involved in the physician antitrust debate on Capitol Hill but didn't provide any details on the group's lobbying strategy.
"Whatever we are doing, we sincerely believe it's in the best interest of all providers," she said.