Philanthropy or monopoly? FTC challenges Colorado IPA

Article Abstract:

A group of physicians in Grand Junction, CO, formed an independent practice association (IPA) to serve the medically indigent in the area, in cooperation with a managed health plan called Rocky Mountain Health Maintenance Organization. After complaints from other local physicians, the Federal Trade Commission threatened to break up the IPA, which includes about 85% of the physicians in Mesa County, CO. The association's members are accused of price fixing and anticompetitive action.

Medicaid, Health aspects, Investigations, Antitrust law, Contracts, United States. Federal Trade Commission, Grand Junction, Colorado

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Court overturns landmark fraud case

Article Abstract:

A federal appeals court reversed the conviction of Hanlester Network, a California physicians' limited partnership, for referring patients to a SmithKline Beecham laboratory in which the doctors owned shares. Although the anti-kickback law was violated, the court held that criminal intent was not proven. Also, the Anti-Kickback Enforcement Act was not yet in effect when the case was first prosecuted, in 1989.

Health Programs, Public health, Medical referral, United States. Department of Health and Human Services, SmithKline Beecham Clinical Laboratories Inc.

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Federal government to appeal anti-kickback decision

Article Abstract:

The Inspector General, June Gibbs Brown, plans to seek review of a decision by the 9th Circuit Court of Repeals to reverse the conviction of Hanlester Network for kickbacks. Judges narrowly defined criminal intent requiring a two-part test that will make it harder for prosecutors to prove violations of the law. Also suggested are proposals to ask Congress to strengthen the anti-kickback law.

Regulation, Licensing, and Inspection of Miscellaneous Commercial Sectors, Health Regulation, Medical law, Criminal intent

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