Independent Physician Association Enforcement Not Forgotten

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On September 30, 2022, the Federal Trade Commission (FTC) obtained civil monetary penalties in the amount of $263,000 from San Juan IPA, Inc. (“San Juan”), an independent physician association operating in northwestern New Mexico. The FTC also proposed a settlement order to address conduct raised in the FTC’s complaint.

In that complaint, the FTC alleged that San Juan violated its 2005 consent order with the FTC, which prohibited San Juan from (i) negotiating with managed care on behalf of San Juan’s physician members, (ii) refusing to deal with payors, and (iii) facilitating such conduct among the physicians. The FTC’s 2022 complaint alleged that San Juan had refused, or issued threats to refuse, to deal with payors and had attempted to negotiate the price terms of payor agreements. Interestingly, according to the complaint, the alleged violations occurred in 2014 and 2017, years before the complaint was filed.

In addition to the monetary penalty, the proposed order, among other things, requires San Juan to (i) provide the FTC with copies of any new payor contracts, along with descriptions of how San Juan complied with the FTC’s requirements; (ii) send a copy of the complaint and judgment to each new payor for the next five years; and (iii) consent to extending the 2005 consent order to June 2030 (it otherwise would have expired in 2025).

This enforcement action could be an example of the new rigor that the FTC is applying to review of and compliance with consent orders.

 

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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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