FTC Settles Price-Fixing Charges Against Two Separate Physicians´ Groups

On December 24, 2008, the Federal Trade Commission (FTC) announced the settlement of two administrative actions, each of which dealt with a different physician group that negotiated fees collectively and refused, or threatened to refuse, to deal with health insurance companies (payers) unless the payers agreed to rate increases. The proposed settlements prohibit the physician groups from engaging in such future conduct and, most notably, provide guidance as to how they may lawfully enter into collective arrangements through clinical and financial integration. In structuring a means of escaping antitrust liability for joint contracting through financial and clinical integration, the FTC again signals its desire for health care organizations to pursue efficiencies in this manner. However, it also underscores that unless a physician group qualifies as a financial risk sharing or clinically integrated joint arrangement, physicians should negotiate fees with payers