As independent practice associations shed capitated contracts--a primary defense against antitrust prosecution--they are coming under increased Federal Trade Commission scrutiny.
For example, the FTC filed a complaint Sept. 17 against 600-physician North Texas Specialty Physicians in Fort Worth. The complaint says NTSP should do nothing more than forward proposed fee levels between its members and contracting plans. It says the IPA no longer accepts enough risk through capitated contracts, which would allow it to be viewed as an integrated group, but NTSP still plays a very active negotiating role for its doctors.
"Only about one-half of NTSP's participating physicians--and few if any primary care providers--participate in any risk-sharing arrangements," the complaint says.
"The tide has turned against physician networks, and they have to be extremely careful," says Jed Morrison, a healthcare antitrust attorney in San Antonio, adding that the FTC entered into consent agreements with seven IPAs around the country over the summer.