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Related Experiment Videos

Antitrust implications of physicians' responses to managed care

S E Lawton1, R F Leibenluft, L E Loeb

  • 1Hogan & Hartson, L.L.P., Washington, D.C. 20004, USA.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|May 1, 1995
PubMed
Summary

Physicians face antitrust scrutiny when negotiating with managed care organizations. Consulting legal counsel is crucial before collaborating to navigate these complex antitrust laws.

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Area of Science:

  • Healthcare Law
  • Antitrust Law
  • Managed Care

Background:

  • Private market forces are significantly altering medical care organization.
  • Managed care arrangements are increasingly prevalent for employer-sponsored health insurance.
  • Physicians in private practice and academia face pressure from managed care organizations to control costs and accept oversight.

Purpose of the Study:

  • To advise members of the Infectious Diseases Society of America (IDSA) on antitrust law principles.
  • To clarify the applicability of federal and state antitrust laws within the managed care context.
  • To guide physicians on negotiating with managed care organizations while avoiding legal pitfalls.

Main Methods:

  • Legal analysis of antitrust laws relevant to physician negotiations.

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  • Review of physician responses to managed care demands.
  • Consultation with legal counsel (Hogan & Hartson) to provide guidance.

    • Main Results:

    • Physicians can take steps to negotiate successfully with managed care organizations.
    • Certain physician conduct during negotiations may violate antitrust laws.
    • Collaboration among physicians requires careful consideration of antitrust implications.

    Conclusions:

    • Physicians must be aware of antitrust laws when dealing with managed care.
    • Seeking legal counsel is essential before engaging in collective action with other physicians.
    • Proactive legal guidance is recommended to navigate the evolving managed care landscape.