Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

How PHOs can avoid price-fixing charges.

D A Ettinger1

  • 1Honigman Miller Schwartz and Cohn, Detroit, MI, USA.

Healthcare Financial Management : Journal of the Healthcare Financial Management Association
|June 6, 1996
PubMed
Summary
This summary is machine-generated.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Government agencies soften stance on what constitutes price fixing.

Healthcare financial management : journal of the Healthcare Financial Management Association·1997
Same author

Antitrust issues facing multiprovider networks.

Journal of health and hospital law : a publication of the American Academy of Hospital Attorneys of the American Hospital Association·1995
Same author

The "dirty words" of antitrust.

The Medical staff counselor·1993
Same author

New guidelines may facilitate hospital mergers.

Health progress (Saint Louis, Mo.)·1992
Same author

Avoiding antitrust liability for denial of access to resources: some safe harbors.

The Medical staff counselor·1992
Same author

Justice lacks a credible case against some hospital mergers.

Modern healthcare·1990
Same journal

Highlights from the HFM blog.

Healthcare financial management : journal of the Healthcare Financial Management Association·2018
Same journal

Hospitals face challenges from Medicare cost and payment trends.

Healthcare financial management : journal of the Healthcare Financial Management Association·2018
Same journal

The fate of value-based care with an ACA repeal.

Healthcare financial management : journal of the Healthcare Financial Management Association·2018
Same journal

Beyond the Medicare annual well visit: maximizing revenue for hospital-owned practices.

Healthcare financial management : journal of the Healthcare Financial Management Association·2018
Same journal

Incorporating social determinants into population health management.

Healthcare financial management : journal of the Healthcare Financial Management Association·2018
Same journal

Health Care 2020 Part 3: Consolidation.

Healthcare financial management : journal of the Healthcare Financial Management Association·2018
See all related articles

Physician-hospital organizations (PHOs) must carefully navigate antitrust laws during third-party negotiations to avoid legal penalties. The DOJ clarified that PHOs can only engage in pricing discussions if they function as risk-sharing managed care plans or act as neutral messengers.

Area of Science:

  • Healthcare Law
  • Antitrust Compliance
  • Managed Care Negotiations

Background:

  • Physician-hospital organizations (PHOs) face scrutiny regarding antitrust compliance.
  • The Department of Justice (DOJ) has issued guidance on PHOs' negotiation practices with third parties.

Purpose of the Study:

  • To analyze the DOJ's recent settlements concerning PHOs and antitrust law.
  • To clarify permissible and impermissible negotiation activities for PHOs.

Main Methods:

  • Review of DOJ settlements with PHOs in Danbury, Connecticut, and St. Joseph, Missouri.
  • Analysis of the DOJ's stipulations regarding PHO involvement in pricing decisions.

Main Results:

  • PHOs are restricted from direct involvement in pricing negotiations.

Related Experiment Videos

  • Permissible roles for PHOs include acting as a qualified managed care plan with shared financial risk or as a messenger between providers and third parties.

    • Conclusions:

    • PHOs must adhere strictly to antitrust regulations when negotiating with payers.
    • Understanding the DOJ's guidelines is crucial for PHOs to avoid legal repercussions and financial damages.