In a February 13, 2013, advisory opinion, the Federal Trade Commission (FTC) Bureau of Competition stated that it has no present intention to recommend that the FTC challenge a clinical integration program (CIP) proposed by Norman Physician Hospital Organization, a multi-specialty physician-hospital organization (PHO) in Oklahoma. The opinion is the fifth advisory opinion the FTC has issued concerning a clinically integrated managed care contracting network. Four of the advisory opinions were favorable, and one was unfavorable to the respective requesting parties.
It has been almost four years since the FTC last issued an advisory opinion on CIPs, and this is the first advisory opinion the FTC has issued on CIPs since the enactment of the Affordable Care Act, the establishment of accountable care organizations (ACOs) under the Medicare Shared Savings Program (MSSP), and the FTC/U.S. Department of Justice (DOJ) Antitrust Enforcement Policy Statement Regarding ACOs participating in the MSSP (MSSP ACO Policy Statement). In this article, we summarize the Norman PHO advisory opinion and its key takeaways. We also compare the opinion to the CIPs addressed in the FTC’s previous four advisory opinions on the subject.
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Topics: ACOs, Advisory Opinions, Affordable Care Act, Clinical Integration, FTC, Joint Contracting, Norman PHO, Physician Hospital Organizations, Physicians, Rule-of-Reason Analysis
Antitrust & Trade Regulation Updates, Health Law Updates, Insurance Updates
DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.
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