Healthcare Antitrust Attorneys Serving Florida
Healthcare is an industry where practitioners end up working together in networks and other ventures. This all happens against the backdrop of our antitrust laws that forbid certain efforts to restrict competition. Practitioners can work together in some ways to continue providing high-quality care to patients while standing up to the insurance companies that often try to cut their reimbursement rates.
Provider Networks and Other Joint Ventures Are Legal if Certain Rules Are Followed
Antitrust laws do not have a bright-line prohibition against things like provider networks. While there are some things that physicians cannot do, there is an entire set of federal guidelines that allow for doctors to enter into:
- Physician network joint ventures
- Individual practice associations
- Preferred provider organizations
These agreements involve healthcare networks that agree to provide high-quality services for insurance reimbursement while they take steps to control costs. Anytime there is a group of people coming together along with an agreement about prices, antitrust issues are implicated.
Usually, an agreement to fix prices is illegal. However, there is some room for healthcare professionals to work together to negotiate with the insurers so long as they do not set price caps, and their networks are not too large.
Antitrust Presents Complex Issues in Healthcare
Antitrust laws are complex in general, subject to different interpretations as case law evolves. In addition, anytime you add something as complicated as healthcare, doctors have legitimate legal questions to face.
This is where a healthcare antitrust attorney can help. Much of our value comes in being able to help our clients structure their agreements to keep them in compliance with antitrust laws. As circumstances change, we assist physicians in reacting and adjusting, while still following antitrust guidelines. Our attorneys identify potential antitrust complications ahead of time and point them out, so your joint venture can still follow the law.
In addition, we also help our clients as they respond to inquiries from the Department of Justice and the Federal Trade Commission. These agencies enforce antitrust laws, and they will occasionally look into physicians’ business practices. If they find that laws are violated, it could result in enforcement actions and lawsuits. We assist our clients when they receive a letter from the federal government announcing an inquiry or investigation.
Dealing with health insurance companies is an ongoing issue for physicians. These insurers are always changing the rules, with an end goal of trying to increase the share of healthcare dollars that go into their pocket. However, doctors are not powerless. Working within the law, they can stand up for their own interests, working with one another to maximize their own power.
Antitrust Attorneys Helping Physicians and Healthcare Providers
The attorneys at the Law Offices of George M. Sanders are healthcare antitrust attorneys serving Florida with years of experience helping physicians structure arrangements to help their own bottom line while following antitrust laws. Contact us today to schedule your initial consultation to learn about how you can deal with insurers within the federal antitrust laws.