Tag: coordinated interaction

The FTC filed a lawsuit against the three largest prescription drug benefit managers (PBMs)—Caremark Rx, Express Scripts (ESI), and OptumRx—and their affiliated group purchasing organizations (GPOs) for engaging in anticompetitive and unfair rebating practices that have artificially inflated the list price of insulin drugs.

San Juan IPA, Inc., an independent physician association in Farmington, New Mexico, has agreed to pay a $263,000 civil penalty to the FTC to settle allegations that it violated a 2005 order. The 2005 case alleged that San Juan IPA orchestrated agreements among competing member physicians to coordinate joint pricing, collectively negotiated contracts with payors on behalf of members, and refused to deal with payors except on collectively determined price terms.

To remedy these allegations, the 2005 order prohibited San Juan from, among other things, entering into, maintaining, enforcing, or facilitating any agreement or understanding among any physicians (1) to negotiate on behalf of any physician with any payor, (2) to deal, refuse to deal, or threaten to refuse to deal with any payor, (3) regarding any term upon which any physician deals with a payor, including price terms, and (4) not to deal individually with any payor or not to deal with a payor except through the IPA. The order also prohibited San Juan from attempting to engage in, or encouraging any person to engage in, any prohibited action.