Health Care Antitrust Attorneys Near Me
In an ideal world, doctors could focus on caring for their patients without having to worry about their livelihoods. However, health insurance companies and hospitals continuously threaten a physician’s ability to earn a living or to remain independent. Faced with the challenges of declining reimbursements and/or aggressive pressure tactics by large hospitals, doctors need to pursue deliberate and proactive strategies to protect their practices and to defend against violations of their legal rights.
By working together in networks, doctors can improve care, protect their practices and potentially increase the reimbursement rates they receive by providing care more efficiently. Doctor collaborations, however, can raise issues under antitrust laws that prohibit certain types of conduct that unreasonably restrict competition. In the healthcare field, there are ways doctors collaborate with one another in ways that do not violate the antitrust laws. Physician networks, for example, are legal if they are properly structured and don’t give the network improper market power. To comply with the antitrust laws it is important for doctors seeking to collaborate with other doctors to seek advice from health care antitrust attorneys near you.
Consult with a Healthcare Antitrust Attorney to Keep Your Network Legal
While physicians have various options when trying to develop networks such as IPAs, these arrangements can raise serious antitrust issues, if they are not properly structured. One of the most basic antitrust rules is that independent physicians cannot agree to naked price-fixing arrangements. Doctors can, however, form IPAs and other types of networks that don’t constitute naked price-fixing arrangements. If the IPA, for example, is properly clinically integrated or the physician members share adequate risk, the IPA can negotiate provider contracts with health insurers.
Physicians forming networks such as IPAs, need to structure the IPA in a manner that does not give the IPA improper market power. Market power is a complex issue, but a starting point is looking at the share of medical specialties in a geographic area that is controlled by the IPA. A high market share does not conclusively show market power, but having a high market share can raise antitrust concerns that the IPA should evaluate.
We help doctors make these networks possible by reviewing the arrangements and giving legal advice. Oftentimes, antitrust issues could be avoided by advance planning with an experienced attorney. You should expect that your lawyer would help make your arrangement possible by helping you deal with issues at the early stages.
Antitrust Attorneys Could Protect You from Illegal Tactics
The antitrust laws can also protect physician practices from predatory actions taken by hospitals, health insurers and other competitors in the market. With respect to hospitals, for example, many physicians have good relationships with their local hospital[s]. Physicians and hospitals, however, sometimes become competitors. This can happen when a hospital hires physicians, or when physicians open facilities in which they provide services provided by hospitals. Competition is a good thing, and many hospitals compete on the merits. Some hospitals, however, want to use their market power to destroy the competition they face from competing physician practices. This type of predatory conduct can take many different forms. If you believe that a hospital is engaging in predatory conduct against your practice because you are a competitor, contacting a healthcare antitrust attorney makes sense.
Physicians need someone in their corner when they are navigating the business and legal landscape because they often find themselves stuck in a tough spot. If their legal rights are violated, they can take strong action. At the same time, they should be proactive if their business position could be improved through some type of collaborative arrangement with other doctors.
At The Law Offices of George M. Sanders, we take the time to listen to you and learn about your own particular business situation. Then, we give you commonsense legal advice tailored to you to help make business happen or to protect your rights. We are trusted counselors who could be counted upon to partner with you in a practical way.
Experienced Antitrust Attorneys Near Me
If you are a physician and want to know more about how antitrust law affects your practice, contact us at the Law Offices of George M. Sanders, P.C., today for a free consultation. We are experienced antitrust attorneys with extensive knowledge of how physicians compete in the marketplace.