Tag: Health Professional Services

OFTACOOP, a Puerto Rico ophthalmologist cooperative, has agreed to settle FTC charges that its actions harmed competition.  The complaint charges that  OFTACOOP – also known as Cooperativa de Médico Oftalmólogos de Puerto Rico –  unlawfully orchestrated an agreement among competing ophthalmologists to refuse to deal with a health plan, MCS Advantage, Inc., and its network administrator, Eye Management of Puerto Rico, LLC.  OFTACOOP’s concerted refusal to deal forced MCS to abandon its plan to engage Eye Management to create a lower-cost network of ophthalmologists. MCS was also forced to maintain its then-current reimbursement rates paid to ophthalmologists. According to the complaint, OFTACOOP restrained competition without any justification, in violation of federal antitrust law.  The proposed consent order prohibits OFTACOOP from entering into or facilitating agreements between or among ophthalmologists (1) to refuse to deal, or threaten to refuse to deal, with any payor regarding any term, including price terms, or (2) not to deal individually with any payor, or not to deal with any payor other than through OFTACOOP. The order also prohibits information exchanges to facilitate any prohibited conduct, and it bars any attempts to engage in any prohibited conduct. OFTACOOP is also barred from encouraging, suggesting, advising, pressuring, inducing, or trying to induce anyone to engage in any prohibited conduct.

The FTC's order requires CentraCare Health, a healthcare provider in St. Cloud, Minnesota, to release some physicians from “non-compete” contract clauses, allowing them to join competing practices, under a settlement mitigating likely anticompetitive effects from CentraCare’s proposed merger with St. Cloud Medical Group (“SCMG”). CentraCare Health, a non-profit health system in central Minnesota, also includes a multi-specialty physician practice group. SCMG is a physician-owned, multi-specialty practice group that operates four clinics in and around St. Cloud. According to the FTC, CentraCare’s planned acquisition of SCMG would combine the two largest providers of adult primary care, pediatric, and OB/GYN services in the St. Cloud area. By eliminating SCMG as a potential alternative in the St. Cloud area, the acquisition would likely increase CentraCare’s bargaining power vis-à-vis commercial health plans, allowing it to raise reimbursement rates and secure more favorable terms, the complaint states. However, SCMG was failing financially, and a number of physicians had already left the practice. SCMG’s multi-year search did not identify an alternative purchaser to CentraCare for the entire group, but at least one local provider has expressed interest in expanding its practice by hiring some of SCMG’s physicians. The consent order permitted the acquisition to proceed, but lessened its potential anticompetitive effects by requiring CentraCare to allow a number of adult primary care, pediatric, and OB/GYN physicians to leave the health system and work for other local providers or establish a new practice in the area and to provide certain financial incentives to a number of departing physicians.

Keystone Orthopaedic Specialists, LLC, an orthopedic practice formed through a combination of six independent orthopedic practices, agreed to settle charges that the merger substantially reduced competition for orthopedic services in Berks County, Pennsylvania. The complaint also names Orthopaedic Associates, one of the six practices that merged into Keystone in 2011, which was split off from Keystone in 2014. Under the terms of the settlement, Keystone and Orthopaedic Associates are required to obtain prior approval from the Commission before acquiring any interests in each other, before acquiring another orthopedic practice in Berks County, and before hiring or offering membership to an orthopedist who has provided services in Berks County in the past year. The settlement is designed to maintain competition in the relevant market by preserving Orthopaedic Associates’ separation, and allowing health plans to avail themselves of current market conditions by renegotiating existing Keystone contracts.