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Attorneys and
consultants at Beautyman Alvstad, LLP have participated in developing
some of the first PHOs in the country, as far back as the 1970's.
We currently serve as the
administrative headquarters for a number of hospital-physician networks
and market their services to managed care plans and employers.
Beautyman Alvstad, LLP has been
working with the Federal Trade Commission (FTC) to loosen the
restrictions on provider networks and integrated delivery systems.
The FTC has asked for our guidance in
articulating the antitrust relief needed for providers. Please let us
know if you have any antitrust situations which, on a no-name basis,
merit communicating to the FTC. We can, if you would like, use the
provided situations to press for relief.
The current federal regulatory
environment seems slightly more inclined to counteract the bargaining
power of HMOs.
States
are beginning to regulate intermediary entities, like PHOs, that sign
risk contracts with HMOs. We have compiled an assessment of both the
promulgated and proposed regulations in each state. In Pennsylvania, for
example, Statements of Policy published by the Departments of Health and
Insurance are regulating PHOs and other IDSs through HMOs. These
regulations would, in effect, make HMOs an enforcement arm of the state,
adversely impact the independence and bargaining power of PHOs and IDSs,
and potentially compromise the confidentiality of information that PHOs
and IDSs should keep secret for business and antitrust reasons.
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