BSA reaches agreement
Tue, 10 May 2011 20:39:09 GMT —
Pronews 7 Staff Reports
Update 7:00a Wednesday A t a press conference by BSA, it admits that it fully cooperated with the investigations and it is now in full compliance.
BSA says Southwest Health Alliances is a go-between for doctors and insurance companies. At the press conference, it said that the association may have talked to the insurance companies too much. The problem has since been resolved and communication between the doctors and insurance companies will be dealt with on a much stricter basis."We believe that our communications and actions facilitated contracting between physicians and payers to the desire and benefit of both," said Bob Williams, CEO of BSA. "However, inthe eyes of the Texas Attorney General and the Federal Trade Commission the networks communication with physicians exceeded allowable competative boundries."
According to BSA, it does not agree that higher prices were paid for by consumers and businesses."We did not intend to conduct our contracting communications improperly and do not agree that our actions were improper or actually had an adverse impact on either payers or physicians," Williams said.
BSA will not have to pay for any fines but will have to pay for the investigative costs.
Patients should see absolutely no change, Williams added."We remain focused on our mission to provide quality healthcare and Christian love, service and dignity," said Williams. "We were providing great care topatients that were in our walls yesterday, we are today and we will be tomorrow."
Originally Posted Southwest Health Alliances, doing business as BSA Provider Network, has agreed to a settlement with the Federal Trade Commission (FTC) after it allegedly violated federal law since 2000 by fixing prices.
The association represents 900 physicians in the Amarillo area. According to the FTC, the association has been allegedly fixing the prices its member doctors would charge insurers. As a result, consumers and businesses saw higher prices, a news release said.
In the FTC order, it prohibits Southwest Health Alliances from conducting similar business in the future. Additionally, the FTC says the association is currently settling similar charges brought forward by the Texas Attorney General's Office.
Southwest Health is an independent practice association with approximately 900 physician members in the Amarillo area. 300 of those physicians provide primary care services, the FTC says.
According to the FTC, the association has fixed its prices in order to restrain competition.
"Since at least 2000, the network has restrained competition by entering into and implementing agreements to fix the prices and terms at which it would contract with health plans, and has collectively negotiated the terms and conditions under which it would deal with health plans," the FTC release reads.
In short, the FTC says the agreements harmed consumers by increasing physician service prices. Under some circumstances, according to the news release, it may be justified. Those circumstances would be if the independent practice associated clinically or financially integrated its member's practices in order to create efficiencies that justify joint price negotiations.
In the order, the FTC bars Southwest Health from entering into or facilitating agreements among physicians:
1) to negotiate on behalf of any physician with any insurer2) to negotiate with any physician as an insurer3) to deal, refuse to deal, or threaten to refuse to deal with any insurer4) not to deal individually with any insurer, or not to deal with any insurer, except through Southwest Health.
Also in the order, it prohibits Southwest Health from facilitating the exchange of information between physicians on the terms that they will contract with insurers. Additionally, the order contains notifications that will allow the FTC to monitor the associations compliance with its terms. Insurers will also be allowed to terminate any contracts with the network since 2000.
The order does not preclude Southwest Health from engaging in conduct that is reasonably necessary to form or participate in legitimate. It expires in 20 years and was approved by the FTC on a 5-0 vote.
BSA is having a press conference at 4 today and Pronews 7 will update with their response on ConnectAmarillo.com and Pronews 7 at 5.