The Federal Trade Commission reached separate agreements resolving price-fixing allegations with two Colorado-based independent practice associations.
Late News: Price-fixing cases resolved
The FTC contends that Roaring Fork Valley Physicians IPA, negotiated with health plans on behalf of its otherwise competing members in ways that violate federal antitrust law. The allegations include that the association demanded annual cost-of-living adjustments, refused to share contracts with members if the rates were based on Medicare rates and refused to deal with payers that declined to go along with the collective terms.
The agreement does not constitute an admission of wrongdoing or concede the government's version of the facts. A proposed order settling the matter calls for the association to cease negotiating with payers on physicians' behalf. Roaring Fork could not be reached for comment by deadline.
In a separate action, the FTC resolved allegations that the executive director of Boulder Valley Individual Practice Association fielded contract offers from payers personally in order to skirt the terms of a price-fixing settlement the FTC entered with the Boulder, Colo.-based organization in 2008. According to the FTC, Catherine Higgins told an insurer that she could negotiate as an individual on behalf of physicians in spite of the order.
A new complaint describes Higgins as personally involved in the conduct at issue in the FTC's previous action. Without admitting any wrongdoing, Higgins agrees in the consent order to refrain from negotiating on behalf of any physician or relaying contract information between physicians and insurers except as part of a risk-sharing or clinically integrated arrangement that passes antitrust muster.
In a 2008 interview with Modern Healthcare, Higgins said she believed the FTC ignored substantial clinical integration the association facilitated for its members and argued that health plans were always free to deal individually with Boulder Valley's members. She couldn't be reached for comment for this story. Commissioner Thomas Rosch issued a dissenting statement. He described the agreement with Higgins as “a sad conclusion to an unnecessarily sordid tale.”
Send us a letter
Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.