Avoiding Antitrust Liability in Healthcare Provider Messenger Models

CD of Live 90-Minute Telephone Conference with an Interactive Q&A Session Conducted on April 27, 2006 Now available on CD

The Federal Trade Commission (FTC) unanimously affirmed an ALJ decision that concluded that North Texas Specialty Physicians (NTSP) violated the FTC Act by engaging in a horizontal price-fixing conspiracy. This case was the first fully adjudicated physician price-fixing suit on a messenger model filed by the FTC.

The FTC found the NTSP’s use of the purported messenger model -- where a provider network negotiates contracts for its member providers with payors -- amounted to price fixing by using minimum price levels and powers of attorney to negotiate higher prices from payors.

Listen as our authoritative panelists examine potential antitrust risks and liabilities arising from the use of messenger models by healthcare providers -- and the impact of the recent FTC decision.

Christi J. Braun, Ober Kaler, Washington, DC, focuses on the health care industry. She represents providers and insurers in all phases of investigation and litigation arising from antitrust claims and other civil and criminal matters. Prior to joining the firm, she was a staff attorney in the Health Care Services & Products Division of the FTC.

Mary Lou Steptoe, Of Counsel, Skadden Arps, Washington DC, focuses on antitrust and trade regulation matters. Previously, during her 20-year tenure in several FTC top management positions, she worked closely with the DOJ and other agencies to help shape many of the antitrust policies and initiatives currently in place.

Mark Tobey, Chief of the Antitrust and Civil Medicaid Fraud Division, Office of the Texas Attorney General, Austin. He directs all state antitrust and civil medicaid fraud enforcement efforts, including litigation and reviews of significant mergers and acquisitions. Over the past 17 years he has represented the state in civil merger and non-merger enforcement matters involving dozens of different industries.

The panelists will address these and other key questions:

• Does the FTC decision in North Texas Specialty Physicians strike a crippling blow to the provider network model?
• Are provider networks likely to challenge the FTC in court?
• What are potential legal pitfalls for healthcare providers in implementing the messenger model?
• When is the messenger model a legitimate arrangement to lower negotiation costs for healthcare providers and health plans?

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