A managed-care antitrust case that has been lingering for more than two years was resolved last week when a federal judge in Kansas City, Mo., signed a consent decree.
The case involves Heartland Health System, the sole hospital in St. Joseph, Mo., and St. Joseph Physicians, a doctors group, and their jointly owned managed-care product, Health Choice.
The U.S. Justice Department alleged in a complaint that the hospital and doctors conspired to prevent the development of other managed-care plans nearby.
The issues in the original complaint were resolved in a settlement announced in September 1995. However, a group of ancillary providers took issue with a referral policy for discharged patients and filed a friend-of-the-court brief to alter or delete it.
U.S. District Judge Howard Sachs, in signing the decree, noted that the referral policy "is plainly designed to promote use of a Heartland affiliated entity if a patient has no other preference" and could be described as "steering."
Sachs then wrote that he had no authority to turn down the consent decree if it resolved the problems in the original complaint. "A proposed decree must be approved even if it falls short of the remedy the court would impose on its own," Sachs said.
That language pleased the downstream providers because it keeps the door open for additional legal action, a spokesman said.
Richard D. Raskin, a lawyer with Sidley & Austin who represented the doctors, doubted that interpretation.
"I don't think the coalition got what it wanted, unless you think all they really wanted was a fair hearing, and they got that," Raskin said. It would have been inappropriate for the judge to throw out the settlement on such grounds, he added. "He didn't have an evidentiary hearing or a trial or discovery.
"The whole reason we settled was because we didn't want to put ourselves through a trial, even though we strongly disagreed with many of the allegations. The judge honored that."